{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:08:53Z","timestamp":1790726933197,"version":"4.1.0"},"reference-count":83,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["CRC1366 C07"],"award-info":[{"award-number":["CRC1366 C07"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/23\/11093"],"award-info":[{"award-number":["PG\/23\/11093"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["RG\\R1\\241197"],"award-info":[{"award-number":["RG\\R1\\241197"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Nonalcoholic fatty liver disease (NAFLD) with advanced liver fibrosis is associated with cardiovascular disease (CVD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aimed to examine if markers of vascular injury mediate the link between liver fibrosis noninvasive tests (LFNITs) and CVD events, and to compare the incremental predictive value of LFNITs over established CVD risk scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Consecutively recruited individuals (n = 1692) with or without clinically overt coronary artery disease (CAD) from the Athens Cardiometabolic Cohort, were analyzed. Fibrosis-4 index (FIB-4), NAFLD Fibrosis score (NFS), and BARD score were evaluated for direct and indirect associations with indices of subclinical arterial injury including carotid maximal wall thickness (maxWT) and pulse wave velocity (PWV) and with a composite of major adverse cardiovascular events (MACE) that consisted of cardiac death, acute myocardial infarction, or coronary revascularization (39-month median follow-up).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>FIB-4 was the only LFNIT that was consistently associated with multiple markers of vascular injury, irrespective of CAD presence and after controlling for traditional risk factors, surrogates of insulin resistance, or obesity (adjusted P &amp;lt; .05 for all). FIB-4 was also independently associated with CAD presence (adjusted odds ratio [OR] 6.55; 3.48-12.3; P &amp;lt; .001). Increased FIB-4 greater than 2.67 was incrementally associated with an increased risk for MACE (OR [95% CI] 2.00 [1.12-3.55], \u0394AUC [95% CI] 0.014 [0.002-0.026]). These associations were mediated by maxWT rather than PWV. Only FIB-4 (&amp;gt;3.25) was independently and incrementally associated with all-cause mortality (adjusted P &amp;lt; 0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In a cardiometabolically diverse population, the incremental associations of LFNITs with CVD outcomes were mediated by atherosclerotic burden rather than arterial stiffening. FIB-4 consistently demonstrated associations with all study end points. These findings provide mechanistic insights and support the clinical applicability of FIB-4 in CVD prevention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae619","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T20:37:40Z","timestamp":1726000660000},"page":"1115-1127","source":"Crossref","is-referenced-by-count":15,"title":["Incremental Value of Blood-Based Markers of Liver Fibrosis in Cardiovascular Risk Stratification"],"prefix":"10.1210","volume":"110","author":[{"given":"Georgios","family":"Georgiopoulos","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Athanasopoulos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Mavraganis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Konstantaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Papaioannou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Delialis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasthenis","family":"Angelidakis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Sachse","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Papoutsis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beyza","family":"Cavlan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9307-7175","authenticated-orcid":false,"given":"Simon","family":"Tual-Chalot","sequence":"additional","affiliation":[{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University , NE1 7RU Newcastle Upon Tyne ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Zervas","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kateryna","family":"Sopova","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]},{"name":"Department of Cardiology, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim , 68167 Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asimina","family":"Mitrakou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0194-0825","authenticated-orcid":false,"given":"Konstantinos","family":"Stellos","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]},{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University , NE1 7RU Newcastle Upon Tyne ,","place":["UK"]},{"name":"Department of Cardiology, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University , 68167 Mannheim ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim , 68167 Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6444-8734","authenticated-orcid":false,"given":"Kimon","family":"Stamatelopoulos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School , 11528 Athens ,","place":["Greece"]},{"name":"Translational and Clinical Research Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University , NE1 7RU Newcastle Upon Tyne 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