Longitudinal Effect of Hemoglobin Concentration With Incident Ischemic Heart Disease According to Hepatic Steatosis Status Among Koreans.

Dong Hyuk Jung,Yong Jae Lee,Byoungjin Park

doi:10.3389/fcvm.2021.677040

Dong Hyuk Jung, Yong Jae Lee + Show 1 more

Open Access

https://doi.org/10.3389/fcvm.2021.677040

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Abstract

Background: An increased hemoglobin (Hb) level may have detrimental effects on hepatic steatosis (HS) as well as cardiovascular disease (CVD). We investigated Hb's effect on incident ischemic heart disease (IHD) risk in the context of hepatic steatosis (HS).Methods: We assessed 17,521 non-diabetic participants and retrospectively screened for IHD using the Korea National Health Insurance data. High Hb was defined as Hb levels ≥16.3 g/dL in men and 13.9 g/dL in women (>75th percentile). The participants were divided into five groups: reference (group 1), mild HS only (group 2), mild HS and high Hb (group 3), severe HS only (group 4), and severe HS and high Hb (group 5). We assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazards regression models over 50 months from the baseline survey.Results: During the follow-up period, 330 (1.9%) participants developed IHD (310 angina pectoris and 20 myocardial infarction). Compared with the reference group (group 1), the HRs for IHD were 1.04 (95% CI, 0.75–1.46) in group 2, 1.14 (95% CI, 0.70–1.85) in group 3, 1.58 (95% CI, 1.08–2.32) in group 4, and 1.79 (95% CI, 1.15–2.80) in group 5, after adjusting for IHD risk factors.Conclusions: We found the combined effect of HS and Hb levels on the incidence of IHD.

Highlights

Hepatic steatosis (HS) is an asymptomatic condition, but it is the most common liver disease in Western and developed Asian countries [1, 2]
Compared with the reference group, the hazard ratios (HRs) for ischemic heart disease (IHD) were 1.04 in group 2, 1.14 in group 3, 1.58 in group 4, and 1.79 in group 5, after adjusting for IHD risk factors
We found the combined effect of hepatic steatosis (HS) and Hb levels on the incidence of IHD

Summary

Introduction

Hepatic steatosis (HS) is an asymptomatic condition, but it is the most common liver disease in Western and developed Asian countries [1, 2]. A previous study showed that the severity of HS is dose-dependently related to atherosclerosis [10]. These findings are more definite in patients with both hepatic manifestations and other risk factors such as advanced fibrosis and elevated hepatic enzymes [6]. Previous studies have shown that Hb levels may be the modifying factors because an increased Hb level has detrimental effects on both IHD and non-alcoholic fatty liver disease (NAFLD). An increased hemoglobin (Hb) level may have detrimental effects on hepatic steatosis (HS) as well as cardiovascular disease (CVD). We investigated Hb’s effect on incident ischemic heart disease (IHD) risk in the context of hepatic steatosis (HS)

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Discussion

Conclusion