Blood pressure stratification for predicting liver fibrosis risk in metabolic dysfunction associated fatty liver disease.

Abstract

INTRODUCTION AND OBJECTIVES:

The optimal blood pressure (BP) range for patients with metabolic dysfunction-associated fatty liver disease (MAFLD) is currently unknown. This study aimed to explore the relationship between stratified BP levels and MAFLD progression.

PATIENTS AND METHODS:

The data of adults who underwent yearly health check-ups were screened to establish both a cross-sectional and a 6-year longitudinal cohort of individuals with MAFLD. BP was classified into the following categories optimal, normal, high-normal, and hypertension. Liver fibrosis was diagnosed with fibrosis-4 (FIB-4) score, nonalcoholic fatty liver disease fibrosis score (NFS), and aspartate aminotransferase-to-platelet ratio index (APRI).

RESULTS:

A total of 10,232 individuals were included in the cross-sectional cohort. In the MAFLD population, individuals with liver fibrosis had significantly higher BP levels and hypertension prevalence (P < 0.001) than those without. Furthermore, liver fibrosis score was significantly associated with BP levels (P < 0.001). In the 6-year longitudinal cohort of 3661 individuals with MAFLD without liver fibrosis, the incidence rates of liver fibrosis increased with increasing BP levels as follows optimal=11.20%, normal=13.90%, high-normal=19.50%, hypertension=26.20% (log-rank 22.205; P < 0.001). Cox regression analysis showed that both baseline high-normal BP (hazard ratio [HR], 1.820; P=0.019) and hypertension (HR, 2.656; P < 0.001) were predictive of liver fibrosis.

CONCLUSIONS:

BP stratification may be useful in predicting the progression of MAFLD. Individuals having MAFLD with concurrent hypertension or high-normal BP are at a higher risk of liver fibrosis. These findings may provide a criteria for early intervention of MAFLD to prevent liver fibrosis.

• Authors: Jing Liu, Haifeng Lv, Jie Wang, Qianru Zhu, Gongying Chen, Yanming Jiang, Ke Zhao, Li Shao, Junping Shi, Xiaoben Pan
• Journal: Annals of hepatology (Ann Hepatol) 2023 Mar-Apr Vol. 28 Issue 2 Pg. 100892 ISSN: 1665-2681 [Print] Mexico
• PMID: 36577468 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.

Topics

• Adult
• Humans
• Blood Pressure
• Cross-Sectional Studies
• Non-alcoholic Fatty Liver Disease (diagnosis, epidemiology)
• Hypertension (diagnosis, epidemiology)
• Liver Cirrhosis (diagnosis, epidemiology)