Therefore, we wanted to determine whether the fatty liver index (FLI), a surrogate marker and a validated algorithm derived from the serum triglyceride level, body mass index, waist circumference, and γ-glutamyltransferase level, was associated with the prognosis in a population study. The 15-year

all-cause, hepatic-related, cardiovascular disease (CVD), and cancer mortality rates were obtained through the Regional Health Registry in 2011 for 2074 Caucasian middle-aged individuals in the Cremona study, a population study examining the prevalence of diabetes mellitus in Italy. During the 15-year observation MI-503 period, 495 deaths were registered: 34 were hepatic-related, 221 were CVD-related, 180 were cancer-related, and 60 were attributed to other causes. FLI was independently associated with the hepatic-related deaths (hazard ratio = 1.04, 95% confidence interval = 1.02-1.05, P < 0.0001). Age, sex, FLI, cigarette smoking,

and diabetes were independently associated with all-cause mortality. Age, sex, FLI, systolic blood pressure, and fibrinogen were Epigenetics inhibitor independently associated with CVD mortality; meanwhile, age, sex, FLI, and smoking were independently associated with cancer mortality. FLI correlated with the homeostasis model assessment of insulin resistance (HOMA-IR), a surrogate marker of insulin resistance (Spearman’s ρ = 0.57, P < 0.0001), and when HOMA-IR was included in the multivariate analyses, FLI retained check details its association with hepatic-related mortality but not with all-cause, CVD, and cancer-related mortality. Conclusion: FLI is independently associated with hepatic-related mortality. It is also associated with all-cause, CVD, and cancer mortality rates, but these associations appear to be tightly interconnected with the risk conferred by the correlated insulin-resistant state. (HEPATOLOGY 2011;) Nonalcoholic fatty liver disease (NAFLD) is common in insulin-resistant subjects1 and affects 20% to 30% of the adult population and more than 50% of overweight and obese individuals.2 NAFLD

is associated with an increased risk of developing advanced fibrosis and cirrhosis3 and incident type 2 diabetes.4 Because of its association with metabolic syndrome and type 2 diabetes, it has been hypothesized that NAFLD may also be associated with increased rates of cardiovascular disease (CVD)5; in particular, patients with NAFLD have elevated levels of plasma biomarkers of inflammation, endothelial dysfunction, markers of subclinical cardiovascular risk, and a higher prevalence of clinically manifesting CVD.6 Some studies have also reported a higher incidence of major outcomes,7-10 such as nonfatal CVD events,7 deaths due to CVD,8, 9 revascularization procedures,9 and all-cause mortality.