Table 3.
Hazard ratios for CVD risk based on regular PA, stratified by steatotic liver disease group.
| SLD group | Physical activity | N | Event | Follow-up duration |
Incidence rates | Composite | Subgroup | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Adjusted | Adjusted | |||||||||
| Composite CVD event (myocardial infarction or ischemic stroke or cardiovascular mortality) | ||||||||||
| No steatosis | Irregular | 551,331 | 35,961 | 3,114,269.7 | 11.55 | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 180,649 | 9394 | 1,036,603.8 | 9.06 | 0.78 (0.77, 0.80) | 0.82 (0.80, 0.84) | 0.78 (0.77, 0.80) | 0.82 (0.80, 0.84) | ||
| MASLD | Irregular | 787,971 | 47,510 | 4,472,721.9 | 10.62 | 0.92 (0.91, 0.93) | 1.16 (1.14, 1.18) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 198,830 | 10,844 | 1,136,534.0 | 9.54 | 0.83 (0.81, 0.84) | 1.01 (0.98, 1.03) | 0.90 (0.88, 0.92) | 0.87 (0.85, 0.89) | ||
| MetALD | Irregular | 95,149 | 4559 | 542,349.4 | 8.41 | 0.73 (0.71, 0.75) | 1.17 (1.13, 1.21) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 24,280 | 1081 | 139,387.9 | 7.76 | 0.67 (0.63, 0.71) | 1.00 (0.94, 1.06) | 0.92 (0.86, 0.99) | 0.85 (0.80, 0.91) | ||
| ALD | Irregular | 65,844 | 4258 | 368,725.5 | 11.55 | 1.00 (0.97, 1.03) | 1.33 (1.28, 1.38) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 17,256 | 1000 | 97,692.0 | 10.24 | 0.89 (0.83, 0.94) | 1.12 (1.05, 1.20) | 0.89 (0.83, 0.95) | 0.85 (0.79, 0.91) | ||
| p-value | < 0.001 | < 0.001 | – | - | ||||||
| p for interaction | – | – | < 0.001 | 0.005 | ||||||
| Myocardial infarction | ||||||||||
| No steatosis | Irregular | 551,331 | 15,423 | 3,154,108.5 | 4.89 | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 180,649 | 4186 | 1,047,198.7 | 4.00 | 0.82 (0.79, 0.85) | 0.84 (0.81, 0.87) | 0.82 (0.79, 0.85) | 0.84 (0.81, 0.87) | ||
| MASLD | Irregular | 787,971 | 21,731 | 4,527,950.5 | 4.80 | 0.98 (0.96, 1.00) | 1.16 (1.13, 1.19) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 198,830 | 5000 | 1,149,083.9 | 4.35 | 0.89 (0.86, 0.92) | 1.03 (0.99, 1.06) | 0.91 (0.88, 0.93) | 0.89 (0.86, 0.91) | ||
| MetALD | Irregular | 95,149 | 2058 | 547,788.5 | 3.76 | 0.77 (0.74, 0.81) | 1.21 (1.15, 1.28) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 24,280 | 465 | 140,741.9 | 3.30 | 0.68 (0.62, 0.74) | 1.01 (0.91, 1.11) | 0.88 (0.80, 0.97) | 0.83 (0.75, 0.92) | ||
| ALD | Irregular | 65,844 | 1830 | 373,671.4 | 4.90 | 1.00 (0.96, 1.05) | 1.32 (1.24, 1.39) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 17,256 | 429 | 98,947.8 | 4.34 | 0.89 (0.81, 0.98) | 1.12 (1.01, 1.24) | 0.88 (0.80, 0.98) | 0.85 (0.77, 0.95) | ||
| p-value | < 0.001 | < 0.001 | – | - | ||||||
| p for interaction | – | – | < 0.001 | 0.161 | ||||||
| Ischemic stroke | ||||||||||
| No steatosis | Irregular | 551,331 | 18,374 | 3,146,590.7 | 5.84 | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 180,649 | 4816 | 1,045,556.3 | 4.61 | 0.79 (0.76, 0.81) | 0.83 (0.81, 0.86) | 0.79 (0.76, 0.81) | 0.83 (0.81, 0.86) | ||
| MASLD | Irregular | 787,971 | 23,992 | 4,522,191.9 | 5.31 | 0.91 (0.89, 0.93) | 1.18 (1.15, 1.20) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 198,830 | 5508 | 1,148,171.8 | 4.80 | 0.82 (0.80, 0.85) | 1.03 (0.99, 1.06) | 0.90 (0.88, 0.93) | 0.87 (0.85, 0.90) | ||
| MetALD | Irregular | 95,149 | 2355 | 547,080.2 | 4.30 | 0.74 (0.71, 0.77) | 1.16 (1.11, 1.22) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 24,280 | 595 | 140,389.0 | 4.24 | 0.73 (0.67, 0.79) | 1.05 (0.96, 1.14) | 0.98 (0.90, 1.08) | 0.90 (0.82, 0.99) | ||
| ALD | Irregular | 65,844 | 2180 | 372,849.1 | 5.85 | 1.00 (0.96, 1.05) | 1.29 (1.23, 1.36) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 17,256 | 528 | 98,670.2 | 5.35 | 0.92 (0.84, 1.00) | 1.13 (1.03, 1.24) | 0.91 (0.83, 1.01) | 0.87 (0.79, 0.96) | ||
| p-value | < 0.001 | < 0.001 | - | – | ||||||
| p for interaction | – | – | < 0.001 | 0.103 | ||||||
| Cardiovascular mortality | ||||||||||
| No steatosis | Irregular | 551,331 | 6587 | 3,189,572.6 | 2.07 | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 180,649 | 1378 | 1,056,926.6 | 1.30 | 0.63 (0.60, 0.67) | 0.72 (0.68, 0.76) | 0.63 (0.60, 0.67) | 0.72 (0.68, 0.76) | ||
| MASLD | Irregular | 787,971 | 6758 | 4,581,578.5 | 1.48 | 0.72 (0.69, 0.74) | 1.16 (1.11, 1.21) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 198,830 | 1359 | 1,161,620.3 | 1.17 | 0.57 (0.54, 0.60) | 0.89 (0.84, 0.95) | 0.79 (0.75, 0.84) | 0.77 (0.73, 0.82) | ||
| MetALD | Irregular | 95,149 | 560 | 552,945.9 | 1.01 | 0.49 (0.45, 0.54) | 1.22 (1.11, 1.35) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 24,280 | 116 | 141,821.9 | 0.82 | 0.40 (0.33, 0.48) | 0.87 (0.72, 1.05) | 0.81 (0.66, 0.98) | 0.71 (0.58, 0.87) | ||
| ALD | Irregular | 65,844 | 633 | 378,103.8 | 1.67 | 0.81 (0.75, 0.88) | 1.55 (1.41, 1.70) | 1 (Ref.) | 1 (Ref.) | |
| Regular | 17,256 | 128 | 100,010.7 | 1.28 | 0.62 (0.52, 0.74) | 1.10 (0.92, 1.32) | 0.76 (0.63, 0.92) | 0.72 (0.59, 0.86) | ||
| p-value | < 0.001 | < 0.001 | – | - | ||||||
| p for interaction | – | – | < 0.001 | 0.387 | ||||||
The results were obtained using Cox proportional hazards analysis and presented as HR with 95% CI. The follow-up duration is presented as person-years.
Incidence rates are presented per 1000 person-years.
Adjusted model: adjusted for age, sex, income, regular physical activity, CCI score, fasting glucose level, DM duration, insulin use, OHA, CKD, BMI, alcohol consumption, HTN, and dyslipidemia.
ALD, alcohol-related liver disease; BMI, body mass index; CCI, Charlson Comorbidity Index; CI, confidence interval; CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; HR, hazard ratio; HTN, hypertension; MASLD, metabolic dysfunction-associated steatotic liver disease; MetALD, metabolic dysfunction and alcohol-related steatotic liver disease; OHA, oral hypoglycemic agent; PA, physical activity; SLD, steatotic liver disease.