The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease

Abstract Objective This study aims to explore the associations between biomarkers related to inflammation, metabolism, and liver fibrosis and the prevalence of atrial fibrillation(AF) in older patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and to identify potential i...

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Main Authors: Shuai Zhang, Hao Liang, Jun Liu, Zhipeng Huang, Xijing Shi, Ye Zhu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06120-3
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author Shuai Zhang
Hao Liang
Jun Liu
Zhipeng Huang
Xijing Shi
Ye Zhu
author_facet Shuai Zhang
Hao Liang
Jun Liu
Zhipeng Huang
Xijing Shi
Ye Zhu
author_sort Shuai Zhang
collection DOAJ
description Abstract Objective This study aims to explore the associations between biomarkers related to inflammation, metabolism, and liver fibrosis and the prevalence of atrial fibrillation(AF) in older patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and to identify potential indicators that could be conveniently applied in epidemiological studies of AF within this population. Methods A total of 2035 older patients with MASLD who underwent physical examinations at Northern Jiangsu People's Hospital in Jiangsu Province, China, from January 2021 to June 2023 were selected and divided into AF and non-AF groups. Least Absolute Shrinkage and Selection Operator(LASSO) regression was used for variable selection, and multivariate logistic regression analysis, restricted cubic spline analysis(RCS), subgroup analysis, and predictive model evaluation tools were employed to investigate the associations between these indicators and the risk of AF in older MASLD patients. Results Both LASSO regression and multivariate logistic regression analyses indicated that NAFLD Fibrosis Score(NFS) (OR(95% CI) = 1.924(1.464, 2.558)), Albumin-Bilirubin score(ALBI) (OR (95% CI) = 1.299 (1.156, 1.466)), Fibrosis-4(FIB-4) (OR (95% CI) = 1.385 (1.146, 1.694)), and Monocyte to High-Density Lipoprotein Cholesterol Ratio(MHR)(OR (95% CI) = 1.501 (1.247, 1.809)) are independent risk factors for AF in older patients with MASLD. RCS analysis showed significant non-linear associations between NFS, FIB-4, and MHR and the risk of AF in older MASLD patients (P for nonlinear < 0.05). Subgroup analysis revealed significant interaction effects between diabetes and the AF risk associated with NFS, ALBI, and FIB-4, as well as between sex and the AF risk associated with MHR(P for interaction < 0.05). The variable importance ranking results based on the Boruta algorithm, as well as the Receiver Operating Characteristic (ROC) curve and Decision Curve Analysis (DCA), all indicate that NFS and ALBI have high predictive performance and clinical benefits. Conclusion NFS and ALBI are significantly positively correlated with the prevalence of AF in older patients with MASLD and can serve as potential epidemiological predictive indicators.
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spelling doaj-art-c27ea4e466d5444c9e7e28346c0cda992025-08-20T03:04:17ZengBMCBMC Geriatrics1471-23182025-07-0125111210.1186/s12877-025-06120-3The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver diseaseShuai Zhang0Hao Liang1Jun Liu2Zhipeng Huang3Xijing Shi4Ye Zhu5Department of Gastroenterology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityDepartment of Cardiology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityDepartment of Gastroenterology, Northern Jiangsu People’s HospitalDepartment of Geriatrics, Northern Jiangsu People’s HospitalDepartment of Gastroenterology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityDepartment of Cardiology, Northern Jiangsu People’s HospitalAbstract Objective This study aims to explore the associations between biomarkers related to inflammation, metabolism, and liver fibrosis and the prevalence of atrial fibrillation(AF) in older patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and to identify potential indicators that could be conveniently applied in epidemiological studies of AF within this population. Methods A total of 2035 older patients with MASLD who underwent physical examinations at Northern Jiangsu People's Hospital in Jiangsu Province, China, from January 2021 to June 2023 were selected and divided into AF and non-AF groups. Least Absolute Shrinkage and Selection Operator(LASSO) regression was used for variable selection, and multivariate logistic regression analysis, restricted cubic spline analysis(RCS), subgroup analysis, and predictive model evaluation tools were employed to investigate the associations between these indicators and the risk of AF in older MASLD patients. Results Both LASSO regression and multivariate logistic regression analyses indicated that NAFLD Fibrosis Score(NFS) (OR(95% CI) = 1.924(1.464, 2.558)), Albumin-Bilirubin score(ALBI) (OR (95% CI) = 1.299 (1.156, 1.466)), Fibrosis-4(FIB-4) (OR (95% CI) = 1.385 (1.146, 1.694)), and Monocyte to High-Density Lipoprotein Cholesterol Ratio(MHR)(OR (95% CI) = 1.501 (1.247, 1.809)) are independent risk factors for AF in older patients with MASLD. RCS analysis showed significant non-linear associations between NFS, FIB-4, and MHR and the risk of AF in older MASLD patients (P for nonlinear < 0.05). Subgroup analysis revealed significant interaction effects between diabetes and the AF risk associated with NFS, ALBI, and FIB-4, as well as between sex and the AF risk associated with MHR(P for interaction < 0.05). The variable importance ranking results based on the Boruta algorithm, as well as the Receiver Operating Characteristic (ROC) curve and Decision Curve Analysis (DCA), all indicate that NFS and ALBI have high predictive performance and clinical benefits. Conclusion NFS and ALBI are significantly positively correlated with the prevalence of AF in older patients with MASLD and can serve as potential epidemiological predictive indicators.https://doi.org/10.1186/s12877-025-06120-3Metabolic dysfunction-associated steatotic liver diseaseAtrial fibrillationNAFLD Fibrosis ScoreAlbumin-Bilirubin scoreCross-sectional study
spellingShingle Shuai Zhang
Hao Liang
Jun Liu
Zhipeng Huang
Xijing Shi
Ye Zhu
The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
BMC Geriatrics
Metabolic dysfunction-associated steatotic liver disease
Atrial fibrillation
NAFLD Fibrosis Score
Albumin-Bilirubin score
Cross-sectional study
title The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
title_full The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
title_fullStr The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
title_full_unstemmed The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
title_short The association between inflammatory, metabolic, and hepatic fibrosis-related biomarkers and atrial fibrillation in older patients with metabolic dysfunction-associated steatotic liver disease
title_sort association between inflammatory metabolic and hepatic fibrosis related biomarkers and atrial fibrillation in older patients with metabolic dysfunction associated steatotic liver disease
topic Metabolic dysfunction-associated steatotic liver disease
Atrial fibrillation
NAFLD Fibrosis Score
Albumin-Bilirubin score
Cross-sectional study
url https://doi.org/10.1186/s12877-025-06120-3
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