Alcoholic and Nonalcoholic Fatty Liver Disease and Incident Hospitalization for Liver and Cardiovascular Diseases

Yoosoo Chang, Juhee Cho, Yong Kyun Cho, Ara Cho, Yun Soo Hong, Di Zhao, Jiin Ahn, Chong Il Sohn, Hocheol Shin, Eliseo Guallar, Seungho Ryu

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background & Aims: We compared the associations of nonalcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (AFLD) with risk of incident hospitalization for liver and cardiovascular diseases. Methods: We collected data from the Kangbuk Samsung Health Study on 218,030 men and women in Korea who underwent a health examination from 2011 through 2016. Fatty liver disease (FLD) was detected by ultrasound during the initial examination. The Fibrosis-4 index was used to identify individuals with liver fibrosis. Participants were followed up for as long as 5.9 years and data on hospitalizations for liver and cardiovascular diseases were collected. Results: The prevalence of NAFLD was 22.0% and the prevalence of AFLD was 6.4%. Over a median follow-up period of 4.2 years, we observed 51 and 1097 incident cases of liver disease– or cardiovascular disease–related hospitalizations, respectively. After adjustment for potential confounders, the multivariable-adjusted hazard ratios for liver disease–related hospitalization, comparing NAFLD and AFLD with the reference category (no excessive alcohol intake and no FLD), were 1.73 (95% CI, 0.76–3.96) and 5.00 (95% CI, 2.12–11.83), respectively. The corresponding hazard ratios for cardiovascular disease hospitalization were 1.20 (95% CI, 1.02–1.40) and 1.08 (95% CI, 0.86–1.34), respectively. Among participants with FLD, the risk of liver disease–related hospitalization increased with high Fibrosis-4 index scores, whereas the risk of incident cardiovascular disease did not. Conclusions: In a large cohort study, we found an increased risk of liver disease–related hospitalizations for patients with NAFLD or AFLD, especially among those with Fibrosis-4 index scores. An increased risk of cardiovascular disease–associated hospitalization was observed in patients with NAFLD but not AFLD.

Original languageEnglish (US)
Pages (from-to)205-215.e7
JournalClinical Gastroenterology and Hepatology
Issue number1
StatePublished - Jan 2020


  • Alcohol Consumption
  • CVD
  • Heart
  • Risk Factors

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


Dive into the research topics of 'Alcoholic and Nonalcoholic Fatty Liver Disease and Incident Hospitalization for Liver and Cardiovascular Diseases'. Together they form a unique fingerprint.

Cite this