Association Between Hypertension and the Prevalence of Liver Steatosis and Fibrosis

Abstract

Background Hypertension (HTN) and non-alcoholic fatty liver disease (NAFLD) usually occur together and have some common pathophysiological symptoms. In this study, we determined the relationship between HTN status and the rates of liver steatosis and fibrosis based on the liver stiffness measurement and controlled attenuation parameter obtained by performing liver transient ultrasound elastography (TUE). Methods To perform this cross-sectional study, data were obtained from the National Health and Nutrition Examination Survey for 2017-March 2020 Pre-pandemic cycle. The relationship between HTN and the rates of liver steatosis and fibrosis was analyzed by constructing a multivariate logistic regression model. We also conducted subgroup analyses based on the age, gender, ethnicity, and body mass index (BMI) of the patients. Results In total, 4,837 participants were recruited, including 2,375 participants with HTN and 2,462 participants without HTN. After adjusting possible confounders, HTN was positively related to the liver steatosis rate (OR = 1.4, 95% CI: 1.1–1.8). Such HTN-associated incidences were higher among males (OR = 1.6, 95% CI: 1.1–2.3), non-Hispanic African American individuals (OR = 1.9, 95% CI: 1.1–3.5), and participants with BMI ≥ 25 < 30 kg/m2 (OR = 1.7, 95% CI: 1.1–2.5). Additionally, HTN was positively associated with the fibrosis rate (OR = 2.0, 95% CI: 1.3–3.0), especially among females (OR = 2.6, 95% CI: 1.3–5.1), among individuals who were 40–59 years old (OR = 2.3, 95% CI: 1.1–4.6), 60–80 years old (OR = 2.2, 95% CI: 1.2–4.1), non-Hispanic Caucasian (OR = 3.0, 95% CI: 1.6–5.9), among those with BMI ≥ 25 < 30 kg/m2 (OR = 3.0, 95% CI: 1.1–8.1), and those with BMI ≥ 30 kg/m2 (OR = 2.0, 95% CI: 1.2–3.3). Conclusions The results of this study showed that HTN status was positively associated with liver steatosis and fibrosis rates, especially for subjects with BMI ≥ 25 kg/m2. The relationship was also affected by the ethnicity of the participants.