Abstract：
BACKGROUND: We assessed the relationship of liver fibrosis score with incident dementia in a large, national sample.
METHODS: For this retrospective cohort study, data of dementia-free individuals aged 40-69 years were derived from electronic records of the largest healthcare provider in Israel. The association between liver fibrosis score (FIB-4), assessed from routine laboratory measurements, and incident dementia was explored through multivariate cox regression models.
RESULTS: Of the total sample (N = 826,578, mean age 55 ± 8 years at baseline), 636,967 (77%) had no fibrosis, 180,114 (21.8%) had inconclusive fibrosis status and 9497 (1.2%) had high risk for advanced fibrosis. Over a median follow-up of 17 years, 41,089 dementia cases were recorded. Inconclusive liver fibrosis and advanced fibrosis were associated with increased dementia risk (HR = 1.09, 95%CI: 1.07-1.11 and HR = 1.18, 95%CI: 1.10-1.27, respectively). This association remained robust through seven sensitivity analyses.
CONCLUSIONS: Liver fibrosis assessed through a serum-based algorithm may serve as a risk factor for dementia in the general population.
CONCLUSIONS: Liver fibrosis may predict dementia diagnosis in the general population. Inconclusive liver fibrosis was associated with 9% increased dementia risk. Advanced liver fibrosis was associated with 18% increased dementia risk. Findings remained robust in sensitivity analyses and after adjustments.
METHODS: For this retrospective cohort study, data of dementia-free individuals aged 40-69 years were derived from electronic records of the largest healthcare provider in Israel. The association between liver fibrosis score (FIB-4), assessed from routine laboratory measurements, and incident dementia was explored through multivariate cox regression models.
RESULTS: Of the total sample (N = 826,578, mean age 55 ± 8 years at baseline), 636,967 (77%) had no fibrosis, 180,114 (21.8%) had inconclusive fibrosis status and 9497 (1.2%) had high risk for advanced fibrosis. Over a median follow-up of 17 years, 41,089 dementia cases were recorded. Inconclusive liver fibrosis and advanced fibrosis were associated with increased dementia risk (HR = 1.09, 95%CI: 1.07-1.11 and HR = 1.18, 95%CI: 1.10-1.27, respectively). This association remained robust through seven sensitivity analyses.
CONCLUSIONS: Liver fibrosis assessed through a serum-based algorithm may serve as a risk factor for dementia in the general population.
CONCLUSIONS: Liver fibrosis may predict dementia diagnosis in the general population. Inconclusive liver fibrosis was associated with 9% increased dementia risk. Advanced liver fibrosis was associated with 18% increased dementia risk. Findings remained robust in sensitivity analyses and after adjustments.
摘要：
背景：我们评估了肝纤维化评分与痴呆的关系，国家样本。
方法：对于这项回顾性队列研究，40-69岁无痴呆患者的数据来自以色列最大的医疗保健提供者的电子记录.肝纤维化评分（FIB-4），从常规实验室测量中评估，通过多变量cox回归模型探讨了痴呆的发生率。
结果：在总样本中（N=826,578，基线时平均年龄55±8岁），636,967（77％）没有纤维化，180,114（21.8％）具有不确定的纤维化状态，而9497（1.2％）具有晚期纤维化的高风险。经过17年的中位随访，记录了41,089例痴呆症病例。不确定的肝纤维化和晚期纤维化与痴呆风险增加相关（分别为HR=1.09，95CI：1.07-1.11和HR=1.18，95CI：1.10-1.27）。通过七项敏感性分析，这种关联仍然稳健。
结论：通过基于血清的算法评估的肝纤维化可能是普通人群中痴呆的危险因素。
结论：肝纤维化可以预测一般人群的痴呆诊断。不确定的肝纤维化与9％的痴呆风险增加相关。晚期肝纤维化与痴呆风险增加18%相关。在敏感性分析和调整后，研究结果仍然稳健。
方法：对于这项回顾性队列研究，40-69岁无痴呆患者的数据来自以色列最大的医疗保健提供者的电子记录.肝纤维化评分（FIB-4），从常规实验室测量中评估，通过多变量cox回归模型探讨了痴呆的发生率。
结果：在总样本中（N=826,578，基线时平均年龄55±8岁），636,967（77％）没有纤维化，180,114（21.8％）具有不确定的纤维化状态，而9497（1.2％）具有晚期纤维化的高风险。经过17年的中位随访，记录了41,089例痴呆症病例。不确定的肝纤维化和晚期纤维化与痴呆风险增加相关（分别为HR=1.09，95CI：1.07-1.11和HR=1.18，95CI：1.10-1.27）。通过七项敏感性分析，这种关联仍然稳健。
结论：通过基于血清的算法评估的肝纤维化可能是普通人群中痴呆的危险因素。
结论：肝纤维化可以预测一般人群的痴呆诊断。不确定的肝纤维化与9％的痴呆风险增加相关。晚期肝纤维化与痴呆风险增加18%相关。在敏感性分析和调整后，研究结果仍然稳健。
