期刊
HEPATOLOGY
卷 73, 期 2, 页码 548-559出版社
WILEY
DOI: 10.1002/hep.31608
关键词
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资金
- Framingham Heart Study [75N92019D00031]
- National Institute of Diabetes and Digestive and Kidney Diseases [K23 DK113252]
- Gilead Sciences
- Echosens Corporation
- Doris Duke Clinical Scientist in Development Award [2019085]
- Boston University School of Medicine Department of Medicine Career Investment Award
- Boston University Clinical Translational Science Institute [UL1 TR001430]
- NHLBI [R01HL128914, 2R01 HL092577, P01HL147835]
- American Heart Association [18SFRN34110082]
- MGH Research Scholars Program
- NIEHS [5P42ES010337]
- NCATS [5UL1TR001442]
- NIDDK [U01DK061734, R01DK106419, P30DK120515, R01DK121378, R01DK124318]
- DOD PRCRP [W81XWH-18-2-0026]
In a community-based cohort, hepatic fibrosis defined by VCTE was associated with multiple cardiovascular risk factors (including obesity, metabolic syndrome, diabetes, hypertension, and high-density lipoprotein cholesterol), even after adjusting for covariates and CAP. Additional longitudinal studies are needed to determine the impact of hepatic fibrosis on incident cardiovascular disease risk factors or events.
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.
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