Nutrición Hospitalaria 05710 / http://dx.doi.org/10.20960/nh.05710
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Association between Life’s Essential 8 and liver fibrosis: NHANES 2017-2018


Fang Qi, Jiahui Yang

Prepublicado: 2025-09-05

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Objective: liver fibrosis and cardiovascular disease (CVD) are intimately linked. This study aimed to investigate the relationship between liver fibrosis and cardiovascular health (CVH), as assessed by the Life’s Essential 8 (LE8) scale. Methods: 3,609 adult participants from the United States participated in this cross-sectional study, which used information from the National Health and Nutrition Examination Survey (NHANES) database for the years 2017–2018. Three categories were established for CVH and its eight metrics: high (80-100), moderate (50-79), and low (0-49). To screen for liver fibrosis, liver stiffness measurement (LSM) was assessed using vibration-controlled elastography (VCTE) with a threshold of 8.0 kPa. Linear and logistic regression were used to evaluate the relationship between CVH and liver fibrosis, smoothed curve fitting was used to investigate the nonlinear relationship, and subgroup analysis was performed to test the robustness of the relationship. Results: total CVH and its subcomponents (diet, PA, BP, blood glucose, and BMI) had an inverse relationship with hepatic fibrosis. In the fully adjusted model, there was a stronger negative connection between the high CVH score group and hepatic fibrosis [odds ratios, OR = 0.10, 95 % confidence intervals, CI (0.05, 0.19)]. Sleep health, nicotine exposure, blood lipids, and liver fibrosis had no statistically significant differences, and the negative link between LE8 and liver fibrosis was stronger in young and middle-aged people. Conclusions: there was a substantial negative connection between LE8 and its subcomponents and liver fibrosis. According to our research, keeping appropriate CVH levels may help lower the prevalence of liver cirrhosis and fibrosis, which would have a major effect on public health.

Palabras Clave: Liver cirrhosis. Heart disease risk factors. Healthy lifestyle. Nutrition surveys.



Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. J Hepatol 2023;79(2):516-37.
DOI: 10.1016/j.jhep.2023.03.017
Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, et al. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Med 2014;12:145.
DOI: 10.1186/s12916-014-0145-y
Younossi ZM, Wong G, Anstee QM, Henry L. The Global Burden of Liver Disease. Clin Gastroenterol Hepatol 2023;21(8):1978-91.
DOI: 10.1016/j.cgh.2023.04.015
Ufere NN, Satapathy N, Philpotts L, Lai JC, Serper M. Financial burden in adults with chronic liver disease: A scoping review. Liver Transpl 2022;28(12):1920-35.
DOI: 10.1002/lt.26514
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet 2021;398(10308):1359-76.
DOI: 10.1016/S0140-6736(21)01374-X
Baratta F, Pastori D, Angelico F, Balla A, Paganini AM, Cocomello N, et al. Nonalcoholic Fatty Liver Disease and Fibrosis Associated With Increased Risk of Cardiovascular Events in a Prospective Study. Clin Gastroenterol Hepatol 2020;18(10):2324-31.e4.
DOI: 10.1016/j.cgh.2019.12.026
Nakashima M, Nakamura K, Nishihara T, Ichikawa K, Nakayama R, Takaya Y, et al. Association between Cardiovascular Disease and Liver Disease, from a Clinically Pragmatic Perspective as a Cardiologist. Nutrients 2023;15(3).
DOI: 10.3390/nu15030748
Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation 2022;146(5):e18-e43.
DOI: 10.1161/CIR.0000000000001078
Sun J, Li Y, Zhao M, Yu X, Zhang C, Magnussen CG, et al. Association of the American Heart Association's new "Life's Essential 8" with all-cause and cardiovascular disease-specific mortality: prospective cohort study. BMC Med 2023;21(1):116.
DOI: 10.1186/s12916-023-02824-8
Chen H, Tang H, Huang J, Luo N, Zhang X, Wang X. Life's Essential 8 and Mortality in US Adults with Chronic Kidney Disease. Am J Nephrol 2023;54(11-12):516-27.
DOI: 10.1159/000533257
Zhang R, Wu M, Zhang W, Liu X, Pu J, Wei T, et al. Association between life's essential 8 and biological ageing among US adults. J Transl Med 2023;21(1):622.
DOI: 10.1186/s12967-023-04495-8
Wang L, Li M, Zhao Z, Xu M, Lu J, Wang T, et al. Ideal Cardiovascular Health Is Inversely Associated with Nonalcoholic Fatty Liver Disease: A Prospective Analysis. Am J Med 2018;131(12):1515.e1-.e10.
DOI: 10.1016/j.amjmed.2018.07.011
Jang EH, Chang Y, Ryu S, Kim S, Kim YH, Sung KC, et al. Cardiovascular Health Metrics in the Development and Regression of Nonalcoholic Fatty Liver Disease: A Cohort Study. J Clin Med 2019;8(5).
DOI: 10.3390/jcm8050610
Fan H, Xu C, Li W, Huang Y, Hua R, Xiong Y, et al. Ideal Cardiovascular Health Metrics Are Associated with Reduced Severity of Hepatic Steatosis and Liver Fibrosis Detected by Transient Elastography. Nutrients 2022;14(24).
DOI: 10.3390/nu14245344
Paulose-Ram R, Graber JE, Woodwell D, Ahluwalia N. The National Health and Nutrition Examination Survey (NHANES), 2021-2022: Adapting Data Collection in a COVID-19 Environment. Am J Public Health 2021;111(12):2149-56.
DOI: 10.2105/AJPH.2021.306517
Perak AM, Lancki N, Kuang A, Labarthe DR, Allen NB, Shah SH, et al. Associations of Maternal Cardiovascular Health in Pregnancy With Offspring Cardiovascular Health in Early Adolescence. JAMA 2021;325(7):658-68.
DOI: 10.1001/jama.2021.0247
Asrani SK. Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis. Clin Gastroenterol Hepatol 2015;13(12):2190-204.
DOI: 10.1016/j.cgh.2015.07.030
Pose E, Pera G, Torán P, Gratacós-Ginès J, Avitabile E, Expósito C, et al. Interaction between metabolic syndrome and alcohol consumption, risk factors of liver fibrosis: A population-based study. Liver Int 2021;41(7):1556-64.
DOI: 10.1111/liv.14830
EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol 2021;75(3):659-89.
DOI: 10.1016/j.jhep.2021.05.025
Xie R, Liu L, Liu C, Xie S, Huang X, Zhang Y. Associations of ethylene oxide exposure and "Life's Essential 8". Environ Sci Pollut Res Int 2023;30(57):121150-60.
DOI: 10.1007/s11356-023-30741-z
Ma H, Wang X, Xue Q, Li X, Liang Z, Heianza Y, et al. Cardiovascular Health and Life Expectancy Among Adults in the United States. Circulation 2023;147(15):1137-46.
DOI: 10.1161/CIRCULATIONAHA.122.062457
Long MT, Zhang X, Xu H, Liu CT, Corey KE, Chung RT, et al. Hepatic Fibrosis Associates With Multiple Cardiometabolic Disease Risk Factors: The Framingham Heart Study. Hepatology 2021;73(2):548-59.
DOI: 10.1002/hep.31608
Heredia NI, Zhang X, Balakrishnan M, Daniel CR, Hwang JP, McNeill LH, et al. Physical activity and diet quality in relation to non-alcoholic fatty liver disease: A cross-sectional study in a representative sample of U.S. adults using NHANES 2017-2018. Prev Med 2022;154:106903.
DOI: 10.1016/j.ypmed.2021.106903
Méndez-Sánchez N, Cerda-Reyes E, Higuera-de-la-Tijera F, Salas-García AK, Cabrera-Palma S, Cabrera-Álvarez G, et al. Dyslipidemia as a risk factor for liver fibrosis progression in a multicentric population with non-alcoholic steatohepatitis. F1000Res 2020;9:56.
DOI: 10.12688/f1000research.21918.1
Zheng J, Chen S, Cai Y, Lin S, Ke S, Liu L. Insufficient nocturnal sleep was associated with a higher risk of fibrosis in patients with diabetes with metabolic associated fatty liver disease. Ther Adv Endocrinol Metab 2020;11:2042018820947550.
DOI: 10.1177/2042018820947550
Jung HS, Chang Y, Kwon MJ, Sung E, Yun KE, Cho YK, et al. Smoking and the Risk of Non-Alcoholic Fatty Liver Disease: A Cohort Study. Am J Gastroenterol 2019;114(3):453-63.
DOI: 10.1038/s41395-018-0283-5
van Kleef LA, Choi HSJ, Brouwer WP, Hansen BE, Patel K, de Man RA, et al. Metabolic dysfunction-associated fatty liver disease increases risk of adverse outcomes in patients with chronic hepatitis B. JHEP Rep 2021;3(5):100350.
DOI: 10.1016/j.jhepr.2021.100350
Patmore LA, Katwaroe WK, van der Spek D, Choi HSJ, Patel K, Brakenhoff S, et al. Association Between the Presence of Metabolic Comorbidities and Liver-Related Events in Patients With Chronic Hepatitis B. Clin Gastroenterol Hepatol 2023;21(12):3089-96.e1.
DOI: 10.1016/j.cgh.2023.03.024
Adinolfi LE, Rinaldi L, Guerrera B, Restivo L, Marrone A, Giordano M, et al. NAFLD and NASH in HCV Infection: Prevalence and Significance in Hepatic and Extrahepatic Manifestations. Int J Mol Sci 2016;17(6).
DOI: 10.3390/ijms17060803
Wang CC, Cheng PN, Kao JH. Systematic review: chronic viral hepatitis and metabolic derangement. Aliment Pharmacol Ther 2020;51(2):216-30.
DOI: 10.1111/apt.15575
Petta S, Eslam M, Valenti L, Bugianesi E, Barbara M, Cammà C, et al. Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age-dependent risk profiling study. Liver Int 2017;37(9):1389-96.
DOI: 10.1111/liv.13397
Raynard B, Balian A, Fallik D, Capron F, Bedossa P, Chaput JC, et al. Risk factors of fibrosis in alcohol-induced liver disease. Hepatology 2002;35(3):635-8.
DOI: 10.1053/jhep.2002.31782
Mantovani A, Csermely A, Petracca G, Beatrice G, Corey KE, Simon TG, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021;6(11):903-13.
DOI: 10.1016/S2468-1253(21)00308-3
Simon TG, Roelstraete B, Hagström H, Sundström J, Ludvigsson JF. Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort. Gut 2022;71(9):1867-75.
DOI: 10.1136/gutjnl-2021-325724
Kofler S, Nickel T, Weis M. Role of cytokines in cardiovascular diseases: a focus on endothelial responses to inflammation. Clin Sci (Lond) 2005;108(3):205-13.
DOI: 10.1042/CS20040174
Targher G, Byrne CD, Tilg H. NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications. Gut 2020;69(9):1691-705.
DOI: 10.1136/gutjnl-2020-320622
Kisseleva T, Brenner D. Molecular and cellular mechanisms of liver fibrosis and its regression. Nat Rev Gastroenterol Hepatol 2021;18(3):151-66.
DOI: 10.1038/s41575-020-00372-7
Vilar-Gomez E, Vuppalanchi R, Gawrieh S, Samala N, Chalasani N. CAP and LSM as determined by VCTE are independent predictors of all-cause mortality in the US adult population. Hepatology 2023;77(4):1241-52.
DOI: 10.1097/HEP.0000000000000023
Liu J, Tan L, Liu Z, Shi R. The association between non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis with blood selenium level based on the NHANES 2017-2018. Ann Med 2022;54(1):2259-68.
DOI: 10.1080/07853890.2022.2110277
Tang M, Liu M, Zhang Y, Xie R. Association of family income to poverty ratio and vibration-controlled transient elastography quantified degree of hepatic steatosis in U.S. adolescents. Front Endocrinol (Lausanne) 2023;14:1160625.
DOI: 10.3389/fendo.2023.1160625

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