Hepatic Fibrosis Associates With Multiple Cardiometabolic Disease Risk Factors: The Framingham Heart Study.

Abstract

BACKGROUND AND AIMS:

NAFLD is increasing in prevalence and will soon be the most common chronic liver disease. Liver stiffness, as assessed by vibration-controlled transient elastography (VCTE), correlates with hepatic fibrosis, an important predictor of liver-related and all-cause mortality. Although liver fat is associated with cardiovascular risk factors, the association between hepatic fibrosis and cardiovascular risk factors is less clear.

APPROACH AND RESULTS:

We performed VCTE, assessing controlled attenuation parameter (CAP; measure of steatosis) and liver stiffness measurement (LSM) in 3,276 Framingham Heart Study adult participants (53.9% women, mean age 54.3 ± 9.1 years) presenting for a routine study visit. We performed multivariable-adjusted logistic regression models to determine the association between LSM and obesity-related, vascular-related, glucose-related, and cholesterol-related cardiovascular risk factors. The prevalence of hepatic steatosis (CAP ≥ 290 dB/m) was 28.8%, and 8.8% had hepatic fibrosis (LSM ≥ 8.2 kPa). Hepatic fibrosis was associated with multiple cardiovascular risk factors, including increased odds of obesity (OR, 1.82; 95% CI, 1.35-2.47), metabolic syndrome (OR, 1.49; 95% CI 1.10-2.01), diabetes (OR, 2.67; 95% CI, 1.21-3.75), hypertension (OR, 1.52; 95% CI, 1.15-1.99), and low high-density lipoprotein cholesterol (OR, 1.47; 95% CI, 1.09-1.98), after adjustment for age, sex, smoking status, alcohol drinks/week, physical activity index, aminotransferases, and CAP.

CONCLUSIONS:

In our community-based cohort, VCTE-defined hepatic fibrosis was associated with multiple cardiovascular risk factors, including obesity, metabolic syndrome, diabetes, hypertension, and high-density lipoprotein cholesterol, even after accounting for covariates and CAP. Additional longitudinal studies are needed to determine if hepatic fibrosis contributes to incident cardiovascular disease risk factors or events.

• Authors: Michelle T Long, Xiaoyu Zhang, Hanfei Xu, Ching-Ti Liu, Kathleen E Corey, Raymond T Chung, Rohit Loomba, Emelia J Benjamin
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 73 Issue 2 Pg. 548-559 (02 2021) ISSN: 1527-3350 [Electronic] United States
• PMID: 33125745 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: © 2020 by the American Association for the Study of Liver Diseases.

Topics

• Cardiometabolic Risk Factors
• Cardiovascular Diseases (epidemiology, etiology)
• Elasticity Imaging Techniques
• Female
• Humans
• Liver (diagnostic imaging, pathology)
• Liver Cirrhosis (complications, diagnosis, epidemiology, pathology)
• Longitudinal Studies
• Male
• Metabolic Syndrome (epidemiology, etiology)
• Middle Aged
• Non-alcoholic Fatty Liver Disease (complications, diagnosis, epidemiology, pathology)
• Prevalence