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Factors associated with advanced hepatic fibrosis in patients with various internal diseases: A multicenter community‐based survey
Author(s) -
Kawaguchi Takumi,
Inokuchi Tetsuaki,
Honma Tomoki,
Itano Satoshi,
Kawasaki Eiji,
Inada Chizuko,
Aoki Toshichika,
Tsumura Naohira,
Araki Akiteru,
Mukae Tokunori,
Torimura Takuji
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13190
Subject(s) - medicine , creatinine , diabetes mellitus , gastroenterology , fibrosis , hepatic fibrosis , logistic regression , endocrinology
Background and Aims Advanced hepatic fibrosis can occur in patients with various diseases, including diabetes mellitus and hypertension. We aimed to investigate the prevalence and risk factors of advanced hepatic fibrosis in patients with various internal diseases. Patients and Methods We performed a community‐based survey in which 1012 patients were enrolled (mean age, 63.1 ± 10.8 years; female/male, 505/507). Hepatic fibrosis was evaluated by Fib‐4 index and patients were classified into high and low Fib‐4 groups. Independent factors for the high Fib‐4 group were analyzed using logistic regression and decision tree analysis. Results A high prevalence of high Fib‐4 index was observed in patients with cardiovascular diseases; 37.1% of patients with hypertension belonged to the high Fib‐4 group. Independent factors associated with the high Fib‐4 group were BMI (OR 0.95, 95%CI 0.918–0.989, P < 0.01), male sex (OR 1.35, 95%CI 1.03–1.78, P < 0.05), and hypertension (OR 1.41, 95%CI 1.03–1.92, P < 0.05). In patients with hypertension, a decision tree algorithm revealed three profiles for Fib‐4 index: 1) creatinine level < 0.76 mg/dL (high Fib‐4; 30.0%), 2) creatinine level ≥ 0.76 mg/dL without sodium‐glucose cotransporter 2 inhibitor (SGLT2i) treatment (high Fib‐4; 48.2%), and 3) creatinine level ≥ 0.76 mg/dL with SGLT2i treatment (high Fib‐4; 23.5%). Conclusions A high prevalence of advanced hepatic fibrosis was observed in patients with hypertension. Hypertension was an independent risk factor, and creatinine level and SGLT2i were divergence variables for advanced hepatic fibrosis. Thus, hypertension with chronic kidney injury may exacerbate hepatic fibrosis, while SGLT2i treatment may ameliorate hepatic fibrosis.