Hepatic Fibrosis Associates With Multiple Cardiometabolic Disease Risk Factors: The Framingham Heart Study
Hepatology Feb 6 2021 - Michelle T. Long ,1 Xiaoyu Zhang,2 Hanfei Xu,2 Ching-Ti Liu ,2 Kathleen E. Corey ,3 Raymond T. Chung,3
Rohit Loomba ,4 and Emelia J. Benjamin
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.
Multivariable‐Adjusted Associations Between Hepatic Fibrosis and Continuous Cardiometabolic Risk Factors
Hepatic fibrosis (as both a continuous and dichotomous measure) was significantly associated with all obesity‐related, liver‐related, glucose‐related, vascular‐related, and cholesterol‐related continuous cardiometabolic traits (Table 3). Hepatic fibrosis (LSM ≥ 8.2) was associated with higher BMI, higher waist circumference, higher CAP, higher log‐ALT and log‐AST, higher fasting glucose, higher log‐hgbA1c, higher SBP and DBP, higher log‐triglycerides, lower total cholesterol, and lower HDL cholesterol compared with those without hepatic fibrosis. After additionally adjusting for BMI or CAP, most of the associations with hepatic fibrosis were attenuated; however, for total cholesterol, the negative association with hepatic fibrosis was stronger after additionally adjusting for BMI or CAP. Hepatic fibrosis (LSM ≥ 8.2) was no longer associated with DBP or log‐triglycerides in CAP‐adjusted models. 作者: StephenW 时间: 2021-2-11 12:23
肝纤维化与多种心脏代谢疾病危险因素相关：Framingham心脏研究
肝病学2021年2月6日-米歇尔·T·朗，1肖张宇，2徐汉飞，2刘庆Ti，2凯瑟琳·E·科里，3雷蒙德·钟，3
Rohit Loomba，4和Emelia J. Benjamin
抽象
背景和目标