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All-cause mortality

Prognostic value of ALBI score for all-cause mortality in metabolic associated fatty liver disease patients: a cohort study from NHANES 2003–2018 | BMC Gastroenterology

by Dr. Michael Lee – Health Editor August 7, 2025

written by Dr. Michael Lee – Health Editor

Study Explores Fatty Liver Disease and Liver Function in US Adults

Washington D.C. – A recent study, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2018, has shed light on the relationship between fatty liver disease and overall liver function in a diverse US population. The research, which received ethical approval from the Centers for Disease Control and Prevention (CDC) Institutional Review Board, focused on identifying and categorizing individuals with Metabolic-Associated Fatty Liver Disease (MAFLD) and assessing their liver health through the Albumin-Bilirubin (ALBI) score.

The study meticulously selected participants, excluding those with incomplete data crucial for the ALBI score or MAFLD diagnosis. To ensure data integrity and account for any missing information, researchers employed a sophisticated multiple imputation technique. This method generated five complete datasets, preserving the intricate relationships between various analytical variables.

Understanding the ALBI Score and MAFLD Classification

The ALBI score, a key metric in this study, is calculated using a formula that incorporates bilirubin and albumin levels in the blood. Lower, more negative ALBI scores indicate better liver function. The researchers adapted the traditional ALBI grading system into three tertile groups (Q1, Q2, and Q3) for more nuanced analysis within their cohort.

Metabolic-Associated Fatty Liver Disease (MAFLD) was identified using the US-FLI, a calculation that considers various physiological markers including ethnicity, age, liver enzymes (gamma-glutamyl transferase), waist circumference, insulin, and glucose levels. A US-FLI score of 30 or higher, coupled with the absence of other established causes of chronic liver disease such as viral hepatitis or significant alcohol consumption, was used to diagnose MAFLD.

Participant Demographics and Health Factors

The study participants were stratified into distinct age groups: young adults (20-39 years), middle-aged adults (40-59 years), and older adults (60 years and above). Racial and ethnic categories included non-Hispanic White, non-Hispanic Black, Mexican American, and other self-identified groups. Educational attainment was categorized into incomplete secondary education, completion of secondary education, and postsecondary education. Socioeconomic status was assessed using the poverty-income ratio (PIR), with participants divided into low-income (PIR ≤ 1.5), middle-income (1.5 < PIR ≤ 3.0), and high-income (PIR > 3.0) brackets. Tobacco exposure history was also documented, classifying individuals as lifetime nonsmokers.

Further details regarding the specific inclusion and exclusion criteria and a comprehensive flowchart illustrating the selection of the study population are provided in Figure 1. This research provides valuable insights into the prevalence and characteristics of fatty liver disease within the US population, contributing to our understanding of liver health and related risk factors.

August 7, 2025 0 comments

Health

Association of liver related biomarkers with incident cardiovascular disease and all-cause mortality in the Hispanic community health study/study of Latinos (HCHS/SOL), a population-based cohort study | BMC Gastroenterology

by Dr. Michael Lee – Health Editor July 30, 2025

written by Dr. Michael Lee – Health Editor

Hispanic Health Study Links Liver Markers to Cardiovascular Risk

New analysis reveals potential early indicators for heart disease and mortality.

Researchers have identified specific liver enzyme levels and fibrosis scores that may signal a heightened risk for cardiovascular disease (CVD) and death among Hispanic and Latino adults. This investigation delves into data from a large-scale health study, offering crucial insights into preventative health strategies.

Study Foundation: The HCHS/SOL Cohort

The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) tracked over 16,000 US Hispanic and Latino adults from diverse backgrounds. Participants, aged 18 to 74, were enrolled between 2008 and 2011 across four major US cities.

The study meticulously defined prevalent cardiovascular disease at its outset. This included individuals showing specific electrocardiogram (ECG) abnormalities indicative of past heart attacks. It also incorporated self-reported medical histories of myocardial infarction, stroke, heart failure, or procedures like angioplasty, stenting, or bypass surgery. After excluding 1,199 participants with existing CVD, a final cohort of 15,216 individuals was analyzed.

The HCHS/SOL study meticulously mapped participant journeys, defining cardiovascular disease (CVD) status at baseline to refine the analysis of its long-term outcomes.

Tracking Health Outcomes

The study’s primary outcome combined new CVD events with all-cause mortality. This was tracked through annual phone interviews and verified via medical records and death certificates. The rigorous process involved expert committee reviews to confirm cardiovascular events, ensuring data accuracy.

All-cause mortality was also confirmed through various channels, including family interviews and vital statistics matching. Participants were followed until December 31, 2017, documenting the occurrence of death, a first CVD event, or the final completed follow-up contact.

Investigating Liver Health Markers

Key variables examined included physical activity assessed by the Global Physical Activity Questionnaire (GPAQ), dietary intake evaluated through the National Cancer Institute method, and body composition metrics like BMI and waist circumference. Blood tests measured glucose, insulin, lipid profiles, and inflammatory markers.

The research focused on liver enzymes like ALT, AST, and GGT, along with the FIB-4 index, a common tool for estimating liver fibrosis. Metabolic dysfunction-associated steatotic liver disease (MASLD) was also assessed, defined by the presence of fatty liver (indicated by the Fatty Liver Index) and at least one metabolic risk factor.

The Fatty Liver Index (FLI) was calculated using a specific formula incorporating BMI, waist circumference, and triglyceride levels, with scores above 60 indicating potential steatosis.

$$ begin{aligned} text{FLI} = & (e^{0.953 times text{log}(TG)} + 0.718 times text{log}(BMI) + 0.718 times text{AST} times text{log}(GGT) + 0.054 times text{Waist Circumference} + 15.745) \ & / (1 + e^{0.953 times text{log}(TG)} + 0.718 times text{log}(BMI) + 0.718 times text{AST} times text{log}(GGT) + 0.054 times text{Waist Circumference}) times 100 end{aligned} $$

Metabolic risk factors included conditions such as diabetes, obesity (BMI > 25), increased waist circumference, hypertension, low HDL cholesterol, high triglycerides, prediabetes, insulin resistance (HOMA-IR ≥ 2.5), and elevated C-reactive protein (hs-CRP).

Statistical Insights and Associations

Statistical analyses employed Cox proportional hazards models to evaluate the link between elevated liver markers (AST/ALT, FIB-4, MASLD) and the risk of CVD or mortality. Models were adjusted for various factors including age, sex, ethnicity, lifestyle behaviors, and metabolic health status.

The study found that higher levels of liver enzymes and fibrosis scores were independently associated with an increased risk of developing cardiovascular disease and all-cause mortality. A recent report from the American Heart Association indicates that nearly half of all adults in the US have some form of cardiovascular disease, highlighting the importance of identifying risk factors.American Heart Association Statistics

These findings suggest that monitoring liver health could play a vital role in cardiovascular risk assessment, particularly within the Hispanic and Latino communities. Further research may elucidate the precise mechanisms linking liver health to systemic cardiovascular outcomes.

July 30, 2025 0 comments

Health

Stillbirth Linked to Higher Long-Term Health Risks for Mothers

by Dr. Michael Lee – Health Editor July 4, 2025

written by Dr. Michael Lee – Health Editor

Okay, I’ve analyzed the provided text. Here’s a summary of the key points and themes discussed, focusing on the relationship between stillbirth and later health outcomes:

Main Argument:

The text argues that stillbirth is associated with an increased risk of developing diabetes, cardiovascular disease (CVD), and possibly increased mortality. It explores potential mechanisms linking these conditions and highlights the importance of considering lifestyle factors and socioeconomic modifiers.

Key Points:

Increased Risk: women with a history of stillbirth may have a higher risk of developing diabetes and CVD later in life. some studies suggest a link between multiple miscarriages and increased diabetes risk.
Underlying Mechanisms:
Glucose Metabolism: Disorders of glucose metabolism may be a common link between stillbirth, diabetes, and CVD. Antiangiogenic status: Stillbirth may be linked to antiangiogenic status, which can increase the risk of CVD.
Nerve Growth Factor (NGF) Deficiency: The text emphasizes the potential role of NGF deficiency. Stillbirth may lead to decreased NGF levels, which can:
Cause apoptosis of pancreatic β-cells, affecting insulin secretion and increasing diabetes risk. Contribute to myocardial cell necrosis and heart failure (HF).
Impair insulin synthesis and secretion function,a decrease in the number of islet beta cells,and the destruction of the islet structure,which triggers or exacerbates the development of diabetes.
Emotional and Lifestyle Factors:
psychological Impact: Stillbirth can cause significant psychological distress (anxiety, stress, acute stress disorder), leading to unhealthy behaviors (altered eating habits, overweight).
Chronic Stress: Repeated stress exposure can lead to chronic stress, disturbances in glucose metabolism, neuroendocrine disorders, and a prolonged low-grade inflammatory response.
Depression: Depression is strongly associated with the development of diabetes and CVD.
Socioeconomic Factors:
Income: Higher income may reduce the risk of cardiovascular death and all-cause death associated with stillbirth through a variety of mechanisms, including access to health care, stress management, and healthy behaviors.
Need for Further Research: The text emphasizes the need for more research to understand the complex relationship between stillbirth and long-term health outcomes, particularly considering lifestyle and socioeconomic factors.

Implications:

Targeted Screening and prevention: Women with a history of stillbirth may benefit from targeted screening and prevention strategies for diabetes and CVD.
Addressing Psychological Well-being: addressing the psychological impact of stillbirth is crucial,as stress and depression can contribute to adverse health outcomes.
Considering Socioeconomic Factors: Interventions should consider socioeconomic factors to reduce health disparities among women affected by stillbirth.

In essence,the text presents a compelling argument for considering stillbirth as a potential risk factor for later-life metabolic and cardiovascular health,highlighting the need for a holistic approach that addresses biological,psychological,and socioeconomic factors.

July 4, 2025 0 comments