Table1_Predictive value of the Framingham steatosis index for cardiovascular risk: a nationwide population-based cohort study.docx

BackgroundNon-alcoholic fatty liver disease (NAFLD) is common and is associated with cardiovascular (CV) disease and mortality. The Framingham steatosis index (FSI) was recently proposed as a diagnostic marker of NAFLD and was calculated from age, body mass index, triglyceride, aspartate aminotransferase, alanine aminotransferase, diabetes history, and hypertension status. We aimed to evaluate the predictive ability of FSI for CV risk using a large-scale population dataset from the Korean National Health Insurance Service–National Health Screening Cohort (NHIS–HEALS).MethodsAmong 514,866 individuals in the NHIS–HEALS, we excluded those who died, had a history of admission due to a CV event, and were heavy drinkers. The final study cohort comprised 283,427 participants. We employed both unadjusted and covariate-adjusted models in Cox proportional hazards regression analyses to determine the association between FSI and major adverse cardiovascular events (MACEs), CV events, and CV mortality.ResultsDuring a median follow-up of 5.9 years, we documented 9,674, 8,798, and 1,602 cases of MACEs, CV events, and CV mortality, respectively. The incidence of MACEs was 1.28%, 2.99%, 3.94%, and 4.82% in the first to fourth quartiles of FSI, respectively. The adjusted hazard ratios (95% confidence interval) for MACEs gradually and significantly increased with the FSI quartiles [1.302 (1.215–1.395) in Q2, 1.487 (1.390–1.590) in Q3, and 1.792 (1.680–1.911) in Q4], following an adjustment for conventional CV risk factors, including age, sex, smoking, drinking, physical activities, low-density lipoprotein cholesterol, estimated glomerular filtration rate, and waist circumference. Participants in the higher quartiles of FSI exhibited a noteworthy increase in the occurrence of CV event. However, upon adjusting for relevant risk factors, the association between FSI and CV mortality did not reach statistical significance.ConclusionOur study suggests that the FSI, which is a surrogate marker of NAFLD, has a prognostic value for detecting individuals at higher risk of CV events.</p

Trends in the prevalence of metabolic syndrome and its components in South Korea: Findings from the Korean National Health Insurance Service Database (2009–2013)

<div><p>Background</p><p>The prevalence of metabolic syndrome has markedly increased worldwide. However, studies in the United States show that it has remained stable or slightly declined in recent years. Whether this applies to other countries is presently unclear.</p><p>Objectives</p><p>We examined the trends in the prevalence of metabolic syndrome and its components in Korea.</p><p>Methods</p><p>The prevalence of metabolic syndrome and its components was estimated in adults aged >30 years from the Korean National Health Insurance Service data from 2009 to 2013. The revised National Cholesterol Education Program criteria were used to define metabolic syndrome.</p><p>Results</p><p>Approximately 10 million individuals were analyzed annually. The age-adjusted prevalence of metabolic syndrome increased from 28.84% to 30.52%, and the increasing trend was more prominent in men. Prevalence of hypertriglyceridemia, low HDL-cholesterol, and impaired fasting plasma glucose significantly increased. However, the prevalence of hypertension decreased in both genders. The prevalence of abdominal obesity decreased in women over 50 years-of-age but significantly increased in young women and men (<50 years).</p><p>Conclusions</p><p>The prevalence of metabolic syndrome is still increasing in Korea. Trends in each component of metabolic syndrome are disparate according to the gender, or age groups. Notably, abdominal obesity among young adults increased significantly; thus, interventional strategies should be implemented particularly for this age group.</p></div

Forest plots of the ORs and CIs of components of metabolic syndrome (2013 versus 2009).

<p>BP = blood pressure, CI = confidence interval, HDL = high-density lipoprotein, OR = odds ratio.</p

Characteristics of Korean adults who participated in regular health check-ups, between 2009 and 2013.

<p>Characteristics of Korean adults who participated in regular health check-ups, between 2009 and 2013.</p

Trends in metabolic syndrome in Korea.

<p>The trends in metabolic syndrome prevalence among Korean adults, who participated in regular health check-ups between 2009 and 2013. <i>A</i>: Overall population (<i>P</i> for trend <0.01). <i>B</i>: Comparison between men and women (<i>P</i> <0.001). <i>C</i>: Age-specific trends of metabolic syndrome and ORs per year between 2009 and 2013. ^*Age-stratified logistic regression was used for the calculation of OR per year. OR = Odds ratio.</p

Proportion of subjects meeting the criteria for components of metabolic syndrome stratified by gender.

<p>Proportion of subjects meeting the criteria for components of metabolic syndrome stratified by gender.</p

The trends of each component of metabolic syndrome.

<p>The trends of each component of metabolic syndrome in individuals stratified by gender. <i>P</i> for trends were all significant (<i>P</i> <0.01). BP = blood pressure, HDL = high-density lipoprotein.</p

Prevalence of metabolic syndrome^* and its components in individuals with or without IFG.

<p>Prevalence of metabolic syndrome^* and its components in individuals with or without IFG.</p

Odds ratios (ORs) and 95% confidence intervals (CI) for progression to MUO based on VAI quartile categories in men.

<p>Odds ratios (ORs) and 95% confidence intervals (CI) for progression to MUO based on VAI quartile categories in men.</p

Baseline clinical and biochemical characteristics of the obese subjects according to the conversion of metabolic health during the study period.

<p>Baseline clinical and biochemical characteristics of the obese subjects according to the conversion of metabolic health during the study period.</p