Table 4.
Associations between healthy lifestyle and all-cause mortality in MAFLD participants with and without elevated liver enzyme.
| No. Death/No. Participants | Model 1 | Model 2 | |
|---|---|---|---|
| HR (95% CI) | HR (95% CI) | ||
| ALT (n = 2611) | |||
| Normal ALT (n = 1924) | |||
| Score 0/1 | 207/528 | 1.00 | 1.00 |
| Score 2 | 261/796 | 0.78 (0.63, 0.97) | 0.81 (0.65, 1.00) |
| Score 3 | 165/502 | 0.70 (0.55, 0.90) | 0.73 (0.57, 0.94) |
| Score 4 | 18/98 | 0.25 (0.17, 0.38) | 0.28 (0.18, 0.43) |
| Per 1-unit increase | 0.79 (0.71, 0.87) | 0.80 (0.72, 0.89) | |
| Elevated ALT (n = 687) | |||
| Score 0/1 | 62/225 | 1.00 | 1.00 |
| Score 2 | 34/236 | 0.44 (0.23, 0.82) | 0.50 (0.25, 0.98) |
| Score 3 | 34/192 | 0.56 (0.30, 1.04) | 0.56 (0.29, 1.07) |
| Score 4 | 5/34 | 0.47 (0.14, 1.54) | 0.57 (0.15, 2.09) |
| Per 1-unit increase | 0.72 (0.52, 0.98) | 0.71 (0.53, 0.94) | |
| p-value for interaction | 0.98 | 0.85 | |
| GGT (n = 2616) | |||
| Normal GGT (n = 1585) | |||
| Score 0/1 | 144/401 | 1.00 | 1.00 |
| Score 2 | 189/654 | 0.72 (0.54, 0.95) | 0.77 (0.56, 1.06) |
| Score 3 | 131/441 | 0.59 (0.45, 0.77) | 0.65 (0.48, 0.88) |
| Score 4 | 14/89 | 0.23 (0.12, 0.45) | 0.29 (0.15, 0.57) |
| Per 1-unit increase | 0.74 (0.66, 0.83) | 0.77 (0.68, 0.87) | |
| Elevated GGT (n = 1031) | |||
| Score 0/1 | 125/352 | 1.00 | 1.00 |
| Score 2 | 106/383 | 0.61 (0.43, 0.86) | 0.61 (0.43, 0.85) |
| Score 3 | 68/253 | 0.79 (0.55, 1.13) | 0.79 (0.56, 1.13) |
| Score 4 | 9/43 | 0.40 (0.20, 0.79) | 0.40 (0.19, 0.85) |
| Per 1-unit increase | 0.81 (0.69, 0.95) | 0.80 (0.68, 0.93) | |
| p-value for interaction | 0.62 | 0.62 |
Survey-weight adjusted multivariable Cox proportional models were used in this analysis. Model 1 was adjusted for age, gender, ethnicity, education, and marital status. Model 2 was adjusted for BMI, WC, CRP, TG, HDL, hypertension, and diabetes in addition to model 1. Cut-off values for liver enzymes: ALT, 40/31 IU/L for men/women; GGT, 51/33 IU/L for men/women. ALT, alanine aminotransferase; AST, aspartate aminotransferase; CI, confidence interval; GGT, γ-glutamyl transferase; HR, hazards ratio; MAFLD, metabolic associated fatty liver disease.