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

Pil Gyu Park; Jung Yoon Pyo; Sung Soo Ahn; Hyun Joon Choi; Jason Jungsik Song; Yong-Beom Park; Ji Hye Huh; Sang-Won Lee

doi:10.3389/fcvm.2022.848121

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

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

Authors

Pil Gyu Park¹, Jung Yoon Pyo¹, Sung Soo Ahn¹, Hyun Joon Choi², Jason Jungsik Song^{1

3}, Yong-Beom Park^{1

3}, Ji Hye Huh⁴, Sang-Won Lee^{1

3}

Affiliations

¹ Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
² Department of Medicine, Yonsei University College of Medicine, Seoul, South Korea.
³ Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea.
⁴ Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea.

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 = (e^{0.953×loge(triglycerides)+0.139×BMI+0.718×loge(GGT)+0.053×waistcircumference-15.745})/(1 + e^{0.953×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.