{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:07:37Z","timestamp":1791216457996,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2017R1A2B2008401"],"award-info":[{"award-number":["NRF-2017R1A2B2008401"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2018R1D1A1B07049620"],"award-info":[{"award-number":["2018R1D1A1B07049620"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cardiovascular Health (CVH) metrics scores are associated with cardiovascular disease but whether CVH scores are associated with nonalcoholic fatty liver disease (NAFLD) is uncertain. Our aim was to investigate associations between CVH scores and development or regression of NAFLD. A cohort study was performed in Korean adults who underwent a comprehensive health examination. The CVH metrics were defined according to the American Heart Association Life\u2019s Simple 7 metrics, ranging from 0 (all metrics considered unhealthy) to 7 (all metrics considered healthy). Fatty liver was diagnosed by ultrasound, and liver fibrosis assessed using NAFLD fibrosis score (NFS). Among 93,500 participants without NAFLD or fibrosis at baseline, 15,899 developed NAFLD, and 998 developed NAFLD plus intermediate\/high NFS. Healthy CVH metrics were inversely associated with NAFLD and also NAFLD with fibrosis. In time-dependent models after updating the CVH score and confounders as time-varying covariate, the multivariable-adjusted hazard ratio (95% confidence intervals) for incident NAFLD plus intermediate\/high NFS participants with CVH metrics score 2, 3, 4, 5, or 6\u20137 to those with score 0\u20131 were 0.86 (0.59\u20131.25), 0.51 (0.36\u20130.73), 0.44 (0.31\u20130.62), 0.20 (0.14\u20130.29) and 0.09 (0.05\u20130.14), respectively. Regression of NAFLD occurred in 9742\/37,517 participants who had NAFLD at baseline with positive association with CVH metrics. Higher CVH scores were significantly associated with both (a) decreased incidence of NAFLD, and (b) regression of existing NAFLD. Promoting adherence to ideal CVH metrics can be expected to reduce the burden of NAFLD as well as cardiovascular disease.<\/jats:p>","DOI":"10.3390\/jcm8050610","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T11:22:35Z","timestamp":1557400955000},"page":"610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Cardiovascular Health Metrics in the Development and Regression of Nonalcoholic Fatty Liver Disease: A Cohort Study"],"prefix":"10.3390","volume":"8","author":[{"given":"Eun-Hee","family":"Jang","sequence":"first","affiliation":[{"name":"Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6945-9050","authenticated-orcid":false,"given":"Yoosoo","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea"},{"name":"Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"},{"name":"Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3927-8646","authenticated-orcid":false,"given":"Seungho","family":"Ryu","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea"},{"name":"Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"},{"name":"Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seolhye","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5630-2145","authenticated-orcid":false,"given":"Ki-Chul","family":"Sung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Kyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-1700","authenticated-orcid":false,"given":"Soo-Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hocheol","family":"Shin","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea"},{"name":"Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Wild","sequence":"additional","affiliation":[{"name":"Usher Institute of Population Health Sciences and informatics, University of Edinburgh, Edinburgh EH8 9AG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK"},{"name":"National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.jhep.2010.06.013","article-title":"Nonalcoholic fatty liver disease: The hepatic trigger of the metabolic syndrome","volume":"53","author":"Salamone","year":"2010","journal-title":"J. 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