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Association between plasminogen activator inhibitor‐1 in young adulthood and nonalcoholic fatty liver disease in midlife: CARDIA
Author(s) -
Campbell Patrick T.,
VanWagner Lisa B.,
Colangelo Laura A.,
Lewis Cora E.,
Henkel Anne,
Ajmera Veeral H.,
LloydJones Donald M.,
Vaughan Douglas E.,
Khan Sadiya S.
Publication year - 2020
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14417
Subject(s) - medicine , nonalcoholic fatty liver disease , steatosis , fatty liver , gastroenterology , plasminogen activator inhibitor 1 , confidence interval , odds ratio , diabetes mellitus , plasminogen activator , endocrinology , disease
Background Prior studies have demonstrated a cross‐sectional association between elevated plasminogen activator inhibitor‐1 (PAI‐1) levels and nonalcoholic fatty liver disease (NAFLD). However, there are no prospective longitudinal assessments of the association between PAI‐1 and NAFLD. We aimed to describe the association between PAI‐1 levels in early adulthood with NAFLD in midlife. Methods Among the 5115 participants in the coronary artery risk development in young adults (CARDIA) study, participants were randomly selected from a subset that was free of obesity, diabetes and hypertension at the 1992‐1993 exam and attended the 2005‐2006 exam (n = 996). A subset of participants (n = 896) also had CT liver fat measured (2010‐2011). Participants with secondary causes of steatosis were excluded (n = 87). NAFLD was defined as liver attenuation ≤51 Hounsfield units. Logistic regression models assessed the association between PAI‐1 and NAFLD. Results Of 809 participants, 53% were female, 37% black with a mean age of 32 years. Median PAI‐1 level at 1st assessment (1992‐1993) was 23.4 ng/mL among participants with NAFLD vs 11.9 ng/mL among those without NAFLD ( P < .0001). Median PAI‐1 level at 2nd assessment (2005‐2006) was 55.6 ng/mL among participants with NAFLD vs 19.5 ng/mL among those without NAFLD ( P < .0001). Higher PAI‐1 levels were independently associated with NAFLD (1st assessment adjusted OR [AOR] 2.16 per 1 standard deviation higher log(PAI‐1) level (95% confidence interval [CI] 1.63‐2.85); 2nd assessment AOR 2.71 (95% CI 2.03‐3.61)). Conclusions Plasma PAI‐1 levels in young adulthood were independently associated with NAFLD in midlife. Further studies may indicate whether PAI‐1 plays a role in NAFLD pathophysiology.