The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.

<h4>Background & aims</h4>Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular related death, particularly in those with hepatic fibrosis. We determined the prevalence of predicted fibrosis based on non-invasive fibrosis markers and the ass...

Full description

Saved in:
Bibliographic Details
Main Authors: Michelle T Long, Alison Pedley, Joseph M Massaro, Udo Hoffmann, Caroline S Fox
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0157517&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850232482600845312
author Michelle T Long
Alison Pedley
Joseph M Massaro
Udo Hoffmann
Caroline S Fox
author_facet Michelle T Long
Alison Pedley
Joseph M Massaro
Udo Hoffmann
Caroline S Fox
author_sort Michelle T Long
collection DOAJ
description <h4>Background & aims</h4>Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular related death, particularly in those with hepatic fibrosis. We determined the prevalence of predicted fibrosis based on non-invasive fibrosis markers and the association of hepatic fibrosis with cardiovascular risk factors.<h4>Methods</h4>Cross-sectional study of 575 Framingham Heart Study participants with NAFLD based on computed tomography. We determined the prevalence of predicted fibrosis based on the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST to platelet ratio index (APRI), the Fibrosis-4 score (FIB4), and the NAFLD Fibrosis Score (NFS). Using multivariable logistic regression models, we examined the association between low, indeterminate, or high risk for fibrosis according to the NFS and various cardiometabolic risk factors.<h4>Results</h4>The predicted risk of fibrosis was 12%, 4%, 5%, and 32% for the NFS, FIB4, APRI, and AST/ALT ratio, respectively. In multivariable models, participants with a high risk for advanced fibrosis by the NFS had a wider pulse pressure (adjusted mean difference = 6.87 mm Hg; p = 0.0002) and an increased odds of hypertension (OR 2.92; p = 0.007) compared to those with low risk of fibrosis. There were no statistically significant differences between other cardiovascular risk factors for those with a high versus low risk of fibrosis.<h4>Conclusions</h4>The AST/ALT ratio, APRI, and NFS give widely disparate predictions of liver fibrosis. Participants with a high risk for fibrosis based on NFS had wider pulse pressure and increased odds of hypertension. Whether modifying these risk factors impacts cardiovascular endpoints in NAFLD patients remains unknown.
format Article
id doaj-art-4e8e634fdea84642b485c4e567424b49
institution OA Journals
issn 1932-6203
language English
publishDate 2016-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-4e8e634fdea84642b485c4e567424b492025-08-20T02:03:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01116e015751710.1371/journal.pone.0157517The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.Michelle T LongAlison PedleyJoseph M MassaroUdo HoffmannCaroline S Fox<h4>Background & aims</h4>Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular related death, particularly in those with hepatic fibrosis. We determined the prevalence of predicted fibrosis based on non-invasive fibrosis markers and the association of hepatic fibrosis with cardiovascular risk factors.<h4>Methods</h4>Cross-sectional study of 575 Framingham Heart Study participants with NAFLD based on computed tomography. We determined the prevalence of predicted fibrosis based on the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST to platelet ratio index (APRI), the Fibrosis-4 score (FIB4), and the NAFLD Fibrosis Score (NFS). Using multivariable logistic regression models, we examined the association between low, indeterminate, or high risk for fibrosis according to the NFS and various cardiometabolic risk factors.<h4>Results</h4>The predicted risk of fibrosis was 12%, 4%, 5%, and 32% for the NFS, FIB4, APRI, and AST/ALT ratio, respectively. In multivariable models, participants with a high risk for advanced fibrosis by the NFS had a wider pulse pressure (adjusted mean difference = 6.87 mm Hg; p = 0.0002) and an increased odds of hypertension (OR 2.92; p = 0.007) compared to those with low risk of fibrosis. There were no statistically significant differences between other cardiovascular risk factors for those with a high versus low risk of fibrosis.<h4>Conclusions</h4>The AST/ALT ratio, APRI, and NFS give widely disparate predictions of liver fibrosis. Participants with a high risk for fibrosis based on NFS had wider pulse pressure and increased odds of hypertension. Whether modifying these risk factors impacts cardiovascular endpoints in NAFLD patients remains unknown.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0157517&type=printable
spellingShingle Michelle T Long
Alison Pedley
Joseph M Massaro
Udo Hoffmann
Caroline S Fox
The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
PLoS ONE
title The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
title_full The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
title_fullStr The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
title_full_unstemmed The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
title_short The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
title_sort association between non invasive hepatic fibrosis markers and cardiometabolic risk factors in the framingham heart study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0157517&type=printable
work_keys_str_mv AT michelletlong theassociationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT alisonpedley theassociationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT josephmmassaro theassociationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT udohoffmann theassociationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT carolinesfox theassociationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT michelletlong associationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT alisonpedley associationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT josephmmassaro associationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT udohoffmann associationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy
AT carolinesfox associationbetweennoninvasivehepaticfibrosismarkersandcardiometabolicriskfactorsintheframinghamheartstudy