Linear Relationship between Hepatic Steatosis Index and Major Adverse Cardiovascular Events in Hypertensive Patients with Obstructive Sleep Apnea: A Real-World Cohort Study from China

作者：Wen Wen, Xintian Cai, Qing Zhu, Junli Hu, Jing Hong, Xiangyang Zhang, Nanfang Li · 发表于：Reviews in Cardiovascular Medicine · 年份：2023 · DOI：10.31083/j.rcm2410280 · 被引用次数：21 · 研究领域：Liver Disease Diagnosis and Treatment、Obstructive Sleep Apnea Research、Cardiovascular Disease and Adiposity

Background: Hypertensive patients with obstructive sleep apnea (OSA) are at a high risk of cardiovascular disease (CVD), but assessments of CVD risk in this population are frequently constrained by the presence of comorbid medical conditions. The noninvasive and convenient hepatic steatosis index (HSI) can not only predict the degree of fatty liver degeneration but also correlates well with the severity of numerous diseases. However, the relationship between the HSI and CVD in hypertensive patients with OSA remains unclear. Methods: This retrospective cohort study included patients aged ≥18 years with hypertension and a primary diagnosis of OSA and grouped them according to their baseline HSI. The primary outcome was new or recurrent major adverse cardiovascular and cerebrovascular events (MACCE), while the secondary outcomes were cardiac and cerebrovascular events. The relationship between the baseline HSI and the risk of endpoint events was evaluated using Kaplan–Meier curves, risk-factor graphs, and Cox regression models, while generalized additive models were used to identify linear relationships. The C-statistic, integrated discrimination improvement (IDI), and net reclassification index (NRI) were used to evaluate the predictive value of HSI increments for endpoint events. Results: A total of 2467 participants were included in the analysis and separated into four groups (Q1–Q4) based on their HSI quartiles. Kaplan–Meier survival curves indicated that patients in the Q4 ...