Association between hypertension and the prevalence of liver steatosis and fibrosis

Huanjie Fu; Hao Yu; Yisheng Zhao; Jinhong Chen; Zhichao Liu

doi:10.1186/s12902-023-01318-1

Association between hypertension and the prevalence of liver steatosis and fibrosis

BMC Endocr Disord. 2023 Apr 20;23(1):85. doi: 10.1186/s12902-023-01318-1.

Authors

Huanjie Fu¹, Hao Yu², Yisheng Zhao², Jinhong Chen³, Zhichao Liu⁴

Affiliations

¹ Department of Cardiovascular, Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300150, China.
² Intensive Care Unit, Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300150, China.
³ School of Rehabilitation Medicine, Weifang Medical University, Weifang, Shandong, 261053, China.
⁴ School of Rehabilitation Medicine, Weifang Medical University, Weifang, Shandong, 261053, China. liuzhichao@wfmc.edu.cn.

Abstract

Background: Hypertension (HTN) and non-alcoholic fatty liver disease (NAFLD) frequently coexist and share pathophysiological symptoms. Based on the liver stiffness measurement and controlled attenuation parameter obtained by performing liver transient ultrasound elastography (TUE), we determined the relationship between HTN status and the rates of liver steatosis and fibrosis in this study.

Methods: To perform this cross-sectional study, data were obtained from the National Health and Nutrition Examination Survey for 2017-March 2020 Pre-pandemic cycle. The relationship between HTN and the rates of liver steatosis and fibrosis was analyzed by constructing a multivariate logistic regression model. The VCTE was performed using a FibroScan® system (model 502, V2 Touch), and CAP was measured at ≥ 274 dB/m for liver steatosis, and the LSM result (median, ≥ 8 kPa) confirmed fibrosis. We also conducted subgroup analyses based on the age, sex, ethnicity, and body mass index (BMI) of the patients.

Results: In total, 4,705 participants were recruited, including 2,287 participants with HTN and 2,418 without HTN. After adjusting possible confounders, HTN was positively related to the liver steatosis rate (OR = 1.4, 95% CI: 1.1-1.8). Such HTN-associated prevalence was higher among males (OR = 1.6, 95% CI: 1.1-2.2), non-Hispanic African American individuals (OR = 2.1, 95% CI: 1.1-3.7), and participants with BMI ≥ 25 < 30 kg/m² (OR = 1.7, 95% CI: 1.1-2.5). Additionally, HTN was positively associated with the fibrosis rate (OR = 2.0, 95% CI: 1.3-3.0), especially among females (OR = 2.6, 95% CI: 1.3-5.2), among individuals who were 40-59 years old (OR = 2.1, 95% CI: 1.0-4.3), 60-80 years old (OR = 2.4, 95% CI:1.3-4.6), non-Hispanic Caucasian (OR = 2.9, 95% CI: 1.5-5.6), among those with BMI ≥ 25 < 30 kg/m² (OR = 3.0, 95% CI: 1.1-8.2), and those with BMI ≥ 30 kg/m² (OR = 2.1, 95% CI: 1.4-3.2).

Conclusion: The results of this study revealed that HTN status was associated with higher rates of liver steatosis and fibrosis, particularly in subjects with BMI ≥ 25 kg/m². The ethnicity of the participants also had an impact on the relationship.

Keywords: Controlled attenuation parameter; Fibrosis; Hypertension; Liver steatosis; Liver stiffness.

MeSH terms

Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Liver / pathology
Liver Cirrhosis* / diagnostic imaging
Liver Cirrhosis* / epidemiology
Liver Cirrhosis* / etiology
Male
Middle Aged
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / diagnostic imaging
Non-alcoholic Fatty Liver Disease* / epidemiology
Nutrition Surveys
Prevalence