{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:58:27Z","timestamp":1765357107973,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Fatty liver index (FLI) is a simple and useful index that evaluates non-alcoholic fatty liver disease (NAFLD), particularly in large epidemiologic studies. Heart failure (HF) is becoming a burden to public health as the global trend toward an aging society continues. Thus, we investigated the effect of FLI on the incidence of HF using large cohort data from the Korean National Health Insurance health database. Methods and Results: A total of 7,958,538 subjects aged over 19 years without baseline HF (men = 4,142,264 and women = 3,816,274) were included. Anthropometric and biochemical measurements were evaluated. FLI scores were calculated and FLI \u2265 60 was considered as having NAFLD. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HF incidence were analysed using multivariable time-dependent Cox proportional hazard models. During a mean follow up of 8.26 years, 17,104 participants developed HF. The FLI components associated with the incidence of HF and FLI showed a causal relationship with HF; the FLI \u2265 60 group had a higher HR for HF (HR 1.493; 95% CIs 1.41\u20131.581) than the FLI &lt; 30 group. Subgroup analysis showed that fatty liver (FLI \u2265 60) with age \u2265 65 years or women displayed higher HR for HF than fatty liver with age &lt; 65 or men, respectively. An increase in FLI score significantly increased the HR for HF except for those with a FLI score change from &lt;30 to 30\u201360. Conclusion: NAFLD defined by FLI and increase in FLI score were associated with the incidence of HF. Further detailed prospective studies are needed.<\/jats:p>","DOI":"10.3390\/diagnostics12030663","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T11:30:38Z","timestamp":1646825438000},"page":"663","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Non-Alcoholic Fatty Liver Disease Defined by Fatty Liver Index and Incidence of Heart Failure in the Korean Population: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2830-1174","authenticated-orcid":false,"given":"Byoungduck","family":"Han","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1650-1278","authenticated-orcid":false,"given":"Gyu Bae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Young","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2521-3064","authenticated-orcid":false,"given":"Kyung-Hwan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koh Eun","family":"Shin","sequence":"additional","affiliation":[{"name":"International Healthcare Center, Korea University Anam Hospital, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Eulji Hospital in Uijeongbu, Eulji University School of Medicine, Uijeongbu 11749, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Gyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Catholic University College of Medicine, Seoul 06591, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung-Do","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3548-8758","authenticated-orcid":false,"given":"Yang-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart Disease and Stroke Statistics\u20142018 Update: A Report from the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4070\/kcj.2016.0429","article-title":"Temporal trends of hospitalized patients with heart failure in Korea","volume":"47","author":"Youn","year":"2017","journal-title":"Korean Circ. 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