Young Adults with Nonalcoholic Fatty Liver Disease defined using Fatty Liver Index can be at increased Risk for Myocardial Infarction or Stroke.

AIM Nonalcoholic fatty liver disease (NAFLD) is associated with increased risk of cardiovascular diseases (CVDs). Because studies of young adults are limited, we investigated the relationship between NAFLD and cardiovascular events among a nationally representative sample of young adults in Korea. METHODS AND RESULTS This population-based cohort study from the Korean National Health Insurance Service included adults who were 20-39 years old when they underwent a health examination from 2009-2012. NAFLD was defined as fatty liver index (FLI) ≥60, and participants were divided into three groups according to FLI (<30, 30-59, and ≥60) to investigate the dose-dependent effect of FLI scores. Among 5,324,410 participants, 9.8% had an FLI ≥60. There were 13,051 myocardial infarctions (MI, 0.39%) and 8,573 strokes (0.26%) during a median follow-up of 8.4 years. In multivariable analysis, NAFLD was associated with a higher risk of MI and stroke (hazard ratio [HR]=1.69; 95% confidence interval [CI]: 1.61-1.77 and HR=1.73; 95% CI: 1.63-1.84, respectively). MI and stroke had dose-depended relationships with FLI (HR=1.28 in FLI 30-59 and 1.73 in FLI ≥60 for MI and HR=1.18 in FLI 30-59 and 1.41 in FLI ≥60 for stroke, respectively). CONCLUSIONS NAFLD was an independent predictor of MI and stroke in young adults. These results suggest that primary prevention of CVD should be emphasized in young adults with NAFLD. This article is protected by copyright. All rights reserved.