Cardiovascular Health (CVH) metrics scores are associated with cardiovascular disease\nbut whether CVH scores are associated with nonalcoholic fatty liver disease (NAFLD) is uncertain.\nOur aim was to investigate associations between CVH scores and development or regression of\nNAFLD. A cohort study was performed in Korean adults who underwent a comprehensive health\nexamination. The CVH metrics were defined according to the American Heart Association Lifeâ??s\nSimple 7 metrics, ranging from 0 (all metrics considered unhealthy) to 7 (all metrics considered\nhealthy). Fatty liver was diagnosed by ultrasound, and liver fibrosis assessed using NAFLD fibrosis\nscore (NFS). Among 93,500 participants without NAFLD or fibrosis at baseline, 15,899 developed\nNAFLD, and 998 developed NAFLD plus intermediate/high NFS. HealthyCVHmetrics were inversely\nassociated with NAFLD and also NAFLD with fibrosis. In time-dependent models after updating the\nCVH score and confounders as time-varying covariate, the multivariable-adjusted hazard ratio (95%\nconfidence intervals) for incident NAFLD plus intermediate/high NFS participants with CVH metrics\nscore 2, 3, 4, 5, or 6-7 to those with score 0-1 were 0.86 (0.59-1.25), 0.51 (0.36-0.73), 0.44 (0.31-0.62),\n0.20 (0.14-0.29) and 0.09 (0.05-0.14), respectively. Regression of NAFLD occurred in 9742/37,517\nparticipants who had NAFLD at baseline with positive association with CVH metrics. Higher CVH\nscores were significantly associated with both (a) decreased incidence of NAFLD, and (b) regression\nJ. Clin. of existing NAFLD. Promoting adherence to ideal CVH metrics can be expected to reduce the burden\nof NAFLD as well as cardiovascular disease.
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