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Hepatic Fibrosis Associates With Multiple Cardiometabolic Disease Risk Factors: The Framingham Heart Study
Author(s) -
Long Michelle T.,
Zhang Xiaoyu,
Xu Hanfei,
Liu ChingTi,
Corey Kathleen E.,
Chung Raymond T.,
Loomba Rohit,
Benjamin Emelia J.
Publication year - 2021
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.31608
Subject(s) - medicine , transient elastography , steatosis , metabolic syndrome , nonalcoholic fatty liver disease , diabetes mellitus , hepatic fibrosis , framingham risk score , odds ratio , fatty liver , gastroenterology , type 2 diabetes , fibrosis , obesity , cardiology , disease , endocrinology , liver fibrosis
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.