FIB-4指数与MAFLD状态对心血管疾病风险的联合影响及亚组分析
戴颖莹 常耀伟*

复旦大学附属中山医院青浦分院，上海市，201700；

摘要：背景：肝纤维化评分（FIB-4）和代谢相关脂肪性肝病（MAFLD）均被认为可能与心血管疾病（CVD）存在关联，但其相互关系及对CVD的预测价值尚未明确。方法：本研究纳入13,548名受试者，依据FIB-4指数及MAFLD状态进行分组，评估其与CVD发生的关系，并在多个亚组（性别、年龄、教育水平、婚姻状况、eGFR）中进行交互作用分析。结果：FIB-4升高与CVD发生显著相关（aOR=1.89，95%CI: 1.26–2.84，P=0.002），MAFLD亦为CVD的独立危险因素（aOR=3.58，95%CI: 2.85–4.51，P<0.001）。当FIB-4升高与MAFLD共存时，CVD风险进一步增加，提示协同作用可能存在。亚组分析显示，该关联在eGFR<90人群中尤为显著（交互作用P=0.049），而性别、年龄、教育水平及婚姻状态等因素未显著改变FIB-4与CVD之间的关系。结论：FIB-4指数与MAFLD状态均可作为CVD风险预测的有效标志物，二者联合可增强对高危个体的识别能力，尤其适用于存在代谢异常或肾功能减退的人群，具有重要的临床评估和干预意义。

关键词：心血管疾病（CVD）；FIB-4指数；代谢相关脂肪性肝病（MAFLD）；肝纤维化

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