Fatty liver can increase the risk of myocardial infarction and stroke by 70%. Whole grains and bariatric surgery may reduce the risk!

*Only for medical professionals to read the latest information about fatty liver! Summary: Young people are not afraid of fatty liver? This disease increases the risk of myocardial infarction and stroke by 70%! Fatty liver is helpless? Let the bariatric surgery come to save your heart and liver! Magnesium can also drive away fatty liver? Eat more whole grains to reduce the risk of fatty liver by half! 1 Are young people afraid of fatty liver? This disease increases the risk of myocardial infarction and stroke by 70%! Myocardial infarction and stroke are often regarded as diseases that only the elderly get, and they are very good at a young age.
How can they have this disease? Don't be too confident! Although most relevant studies have been carried out in middle-aged and elderly people, the risk of myocardial infarction and stroke among young people has been increasing in recent decades
.

At present, more and more young people are also suffering from non-alcoholic fatty liver disease (NAFLD), which may further increase the risk of these diseases
.

Therefore, a recent study published in the journal Diabetes Obes Metab analyzed the impact of fatty liver on the risk of cardiovascular events in young people
.

Figure 1.
1 Study published in Diabetes Obes Metab This study from Sungkyunkwan University used population data from the National Health Insurance Agency of Korea and included 5,324,410 young participants aged 20-39
.

The study used the fatty liver index (FLI) to define fatty liver, which was divided into three groups according to FLI≤30, FLI30-59 and FLI≥60
.

FLI is calculated from body mass index (BMI), waist circumference (WC), gamma-glutamyltransferase (GGT) and triglycerides
.

Figure 1.
2 Fatty liver index (FLI) calculation formula results show that 9.
8% of the participants FLI ≥ 60, these patients are considered to have fatty liver
.

During a median follow-up of 8.
4 years, the researchers recorded a total of 13,051 myocardial infarction cases (0.
39%) and 8,573 stroke cases (0.
26%)
.

Analysis showed that fatty liver was associated with a 69% increase in the risk of myocardial infarction (HR 1.
69, 95% CI 1.
61-1.
77), and a 73% increase in the risk of stroke (HR 1.
73, 95% CI 1.
63-1.
84)
.

The higher the FLI index, the higher the corresponding risk of myocardial infarction and stroke.
Compared with the population with FLI<30, the risk of myocardial infarction and stroke increased by 28% and 18% in people with FLI between 30-59 (HR 1.
28, 95%CI 1.
22-1.
34; HR 1.
18, 95%CI 1.
11-1.
26), the risk of central infarction and stroke increased by 73% and 41% in people with FLI≥60 (HR 1.
73, 95%CI 1.
63-1.
84; HR 1.
41, 95%CI 1.
32-1.
51)
.

Subgroup analysis shows that regardless of your age, gender, high blood pressure, dyslipidemia, or obesity, people with higher FLI have an increased risk of myocardial infarction and stroke
.

Figure 1.
3 The subgroup analysis is basically consistent with the main results.
Before this study, people were not aware of the risk of NAFLD in young people, and young people were particularly prone to think that they were in good health and turned a blind eye to the symptoms of NAFLD
.

The results of this study are a wake-up call for people, telling everyone that it is very dangerous for young people to get NAFLD! In fact, the prevalence of NAFLD among young people has risen to 20%, and the average age of onset is 24 years old
.

Therefore, young people who get NAFLD must not be taken lightly, and they must start to pay attention to the prevention of cardiovascular disease
.

2 Fatty liver is helpless? Let the bariatric surgery come to save your heart and liver! NAFLD may progress to non-alcoholic steatohepatitis (NASH)
.

For NASH patients, there is no treatment that can reduce the risk of serious adverse reactions
.

However, a recent study published in the JAMA journal may change this situation.
The study believes that bariatric surgery may have the potential to reduce the risk of adverse liver events and cardiovascular adverse events in patients with NASH
.

Figure 2.
1 Study published in JAMA This study used data from 1158 adult obese patients in the NASH disease, obesity risk surgical procedure and long-term effectiveness (SPLENDOR) study.
Participants diagnosed NASH and liver fiber through liver biopsy histology They received bariatric surgery or non-surgical treatment respectively
.

The median age of the participants was 49.
8 years, of which 63.
9% were women, the median BMI was 44.
1kg/m2, 650 participants underwent bariatric surgery, and 508 patients underwent non-surgical treatment
.

After a median follow-up of 7 years, it was found that 5 patients in the bariatric surgery group and 40 patients in the non-surgical control group had liver adverse events, including clinical or histological diagnosis of liver cirrhosis, hepatocellular carcinoma, liver transplantation or Death due to liver disease; 39 patients and 60 patients in the two groups had major adverse cardiovascular events, including coronary artery events, cerebrovascular events, heart failure or cardiovascular death
.

Figure 2.
2 Bariatric surgery significantly reduces the risk of adverse events in NASH patients The analysis shows that the cumulative incidence of liver adverse events in the bariatric surgery group and non-surgical control group was 2.
3% (95% CI 0.
00-0.
046) and 9.
6% (95%), respectively.
CI 0.
061-0.
129), the risk of the surgery group was significantly reduced (HR 0.
12, 95% CI 0.
02-0.
63, P=0.
01); the cumulative incidence of cardiovascular adverse events in the two groups was 8.
5% (95%CI 0.
055).
-0.
114) and 15.
7% (95%CI 0.
113-0.
198), the risk of surgery group was significantly reduced (HR 0.
30, 95%CI 0.
12-0.
72, P=0.
007)
.

Within the first year after bariatric surgery, 4 patients died of surgical complications, including gastrointestinal fistula and respiratory failure
.

Figure 2.
3 Bariatric surgery also has the effect of reducing body weight and glycosylated hemoglobin.
Researchers believe that in obese NASH patients, bariatric surgery can significantly reduce the risk of liver adverse events and cardiovascular adverse events
.

At the same time, the review article pointed out that few studies have paid attention to the effectiveness and related risks of bariatric surgery in patients with NASH, and this study fills this gap
.

For patients with appropriate indications for bariatric surgery and NASH progressing to fibrosis stage 1-3, clinicians should consider referral of these patients for bariatric surgery
.

3 Magnesium can also drive away fatty liver? Eat more whole grains to reduce the risk of fatty liver by half! At present, drug treatment for NAFLD has not been popularized, and bariatric surgery is not available to everyone.
Therefore, diet has become an important means of preventing and reversing NAFLD
.

A recent study published in the journal Eur J Nutr found that eating more whole grains can reduce the risk of fatty liver by half! Figure 3.
1 Study published in Eur J Nutr.
This study from Columbia University was originally designed to analyze the relationship between magnesium intake and NAFLD risk
.

The study used data from 2685 participants in the Young Adult Coronary Artery Risk Development (CARDIA) study.
The diet and dietary supplement intake were obtained based on the diet records interviewed in the 7th and 20th years of the study, and the participants were identified The intake of magnesium in the daily diet
.

Among them, non-alcoholic fatty liver disease is defined as insufficient liver density on CT scan ≤ 51Hu
.

During the follow-up period, a total of 629 participants were diagnosed with NAFLD
.

The results showed that the average age of the participants at the 25th year of follow-up was 50.
1 years
.

The recommended dietary intake of magnesium in the United States is 320 mg/day for women and 420 mg/day for men; the average magnesium intake for women in this study was 347 mg/day and 446 mg/day for men, and 48.
9% participated People’s magnesium intake is below this standard
.

The one-fifth of the population with the highest daily intake of magnesium consumes 537 mg, while the one-fifth with the lowest daily intake of magnesium has an intake of 215 mg, which is almost equivalent to cut in half
.

The analysis found that total magnesium intake was negatively correlated with the risk of non-alcoholic fatty liver disease
.

Compared with the participants with the lowest 1/5 total magnesium intake, the highest 1/5 had a 55% lower risk of NAFLD (OR 0.
45, 95% CI 0.
23-0.
85; P=0.
03)
.

Among the people who did not use magnesium supplements, the risk of NAFLD was significantly reduced in the population with the highest intake of 1/5 (OR 0.
34, 95% CI 0.
14-0.
82; P=0.
04), but among the people who used magnesium supplements This phenomenon was not found (OR 0.
58, 95% CI 0.
23-1.
45; P=0.
20)
.

Studies have found that higher dietary intake of magnesium is associated with a lower risk of NAFLD, but this is not the case in people who use magnesium supplements
.

This may be because this population generally has a relatively high intake of magnesium
.

The difference in magnesium intake between people is small, so there is no obvious difference in relative risk during follow-up
.

Researchers pointed out that the main source of diet for people with high magnesium intake is whole grains
.

Previous studies have also found that the choice of whole grains for NAFLD patients seems to help alleviate the disease
.

Therefore, eating more whole grains may help prevent fatty liver
.

References: [1]REF: Chung GE, Cho EJ, Yoo JJ, et al.
Young Adults with Nonalcoholic Fatty Liver Disease defined using Fatty Liver Index can be at increased Risk for Myocardial Infarction or Stroke.
Diabetes Obes Metab.
2021 Nov 2 .
doi:10.
1111/dom.
14597.
[2]Aminian A,Al-Kurd A,Wilson R,et al.
Association of Bariatric Surgery With Major Adverse Liver and Cardiovascular Outcomes in Patients With Biopsy-Proven Nonalcoholic Steatohepatitis.
JAMA.
2021 11.
doi:10.
1001/jama.
2021.
19569.
[3]Corey KE,Memel ZN.
Bariatric Surgery as a Strategy for Improving Outcomes in Nonalcoholic Steatohepatitis.
JAMA.
2021 Nov 11.
doi:10.
1001/jama.
2021.
17451.
[4]Lu L ,Chen C,Li Y,et al.
Magnesium intake is inversely associated with risk of non-alcoholic fatty liver disease among American adults.
Eur J Nutr.
2021 Nov 6.
doi:10.
1007/s00394-021-02732-8.