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. 2022 Jun 23:9:848121.
doi: 10.3389/fcvm.2022.848121. eCollection 2022.

Fatty Liver Index Independently Predicts All-Cause Mortality in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis but No Substantial Liver Disease

Pil Gyu Park  1 , Jung Yoon Pyo  1 , Sung Soo Ahn  1 , Hyun Joon Choi  2 , Jason Jungsik Song  1   3 , Yong-Beom Park  1   3 , Ji Hye Huh  4 , Sang-Won Lee  1   3
Affiliations

Fatty Liver Index Independently Predicts All-Cause Mortality in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis but No Substantial Liver Disease

Pil Gyu Park et al. Front Cardiovasc Med. .

Abstract

Background: This study investigated whether the fatty liver index (FLI) could predict all-cause mortality and cerebrovascular accident (CVA) during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) without substantial liver disease.

Methods: The medical records of 75 AAV patients with AAV were retrospectively reviewed. An equation for the FLI is as follows: FLI = (e0.953×loge(triglycerides)+0.139×BMI+0.718×loge(GGT)+0.053×waistcircumference-15.745)/(1 + e0.953×loge(triglycerides)+0.139×BMI+0.718×loge(GGT)+0.053×waistcircumference-15.745) × 100. The cut-offs of the FLI were obtained using the receiver operator characteristic (ROC) curve analysis.

Results: The mean age at AAV diagnosis was 59.1 years and 42.7% were male. Eight patients (10.7%) died and 8 patients had CVA during follow-up. When the cut-offs of the FLI for all-cause mortality and CVA were set as the FLI ≥ 33.59 and the FLI ≥ 32.31, AAV patients with the FLI over each cut-off exhibited a higher risk for all-cause mortality or CVA than those without (RR 8.633 and 8.129), respectively. In addition, AAV patients with the FLI over each cut-off exhibited a significantly lower cumulative patients' survival rate or CVA-free survival rate than those without, respectively. In the multivariable Cox analysis, only the FLI ≥ 33.59 at AAV diagnosis was an independent predictor of all-cause mortality during follow-up in AAV patients (HR 10.448).

Conclusion: The FLI at AAV diagnosis can be a potential independent predictor of all-cause mortality and CVA during follow-up in AAV patients. We suggest that physicians measure the FLI at AAV diagnosis and pay more attention to those with a high FLI value for prevention of future mortality and CVA.

Keywords: antineutrophil cytoplasmic antibody; cerebrovascular accident; fatty liver index; mortality; vasculitis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Cut-offs of the FLI for all-cause mortality and CVA. (A) Identification of the cut-off of the FLI for all-cause mortality using the ROC curve. (B) RR of all-cause mortality according to the cut-off of the FLI. (C) Identification of the cut-off of the FLI for CVA using the ROC curve. (D) RR of CVA based on the cut-off of the FLI. (E,F) Identification of the cut-offs of the FLI for ESRD and CVD. FLI, fatty liver index; RR, relative risk; CVA, cerebrovascular accident; ROC, receiver operator characteristic; ESRD, end-stage renal disease; CVD, cardiovascular disease.
FIGURE 2
FIGURE 2
Comparison of cumulative survival rates. AAV patients with the FLI ≥ 33.59 and that ≥ 32.31 at diagnosis exhibited significantly lower cumulative patients’ and CVA-free survival rates than those without, respectively. AAV, ANCA-associated vasculitis; ANCA, antineutrophil cytoplasmic antibody; FLI, fatty liver index; CVA, cerebrovascular accident.
FIGURE 3
FIGURE 3
A hypothesis of the mechanism. AAV, ANCA-associated vasculitis; ANCA, antineutrophil cytoplasmic antibody; IR, insulin resistance; FLI, fatty liver index; NAFLD, non-alcoholic fatty liver disease; CVA, cerebrovascular accident.
See this image and copyright information in PMC

References

    1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised international Chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheum. (2013) 65:1–11. 10.1002/art.37715 - DOI - PubMed
    1. Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis. (2007) 66:222–7. 10.1136/ard.2006.054593 - DOI - PMC - PubMed
    1. Cornec D, Cornec-Le Gall E, Fervenza FC, Specks U. ANCA-associated vasculitis – clinical utility of using ANCA specificity to classify patients. Nat Rev Rheumatol. (2016) 12:570–9. 10.1038/nrrheum.2016.123 - DOI - PubMed
    1. Millet A, Pederzoli-Ribeil M, Guillevin L, Witko-Sarsat V, Mouthon L. Antineutrophil cytoplasmic antibody-associated vasculitides: is it time to split up the group? Ann Rheum Dis. (2013) 72:1273–9. 10.1136/annrheumdis-2013-203255 - DOI - PubMed
    1. Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers. (2020) 6:71. 10.1038/s41572-020-0204-y - DOI - PubMed