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.

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.

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.