Severity of fatty liver is highly correlated with the risk of hypertension and diabetes: a cross-sectional and longitudinal cohort study

• DOI: 10.1007/s12072-023-10576-z
• Publication Date: 2023-09-25T15:02:27Z
• Authors: Chin-I. Shih; Kuan-Ta Wu; Meng-Hsuan Hsieh; Jeng-Fu Yang; Yi-Yu Chen; Wei-Lun Tsai; Wen-Chi Chen; Po-Cheng Liang; Yu-Ju Wei; Pei-Chien Tsai; Po-Yao Hsu; Ming-Yen Hsieh; Yi-Hung Lin; Tyng-Yuan Jang; Chih-Wen Wang; Ming-Lun Yeh; Chung-Feng Huang; Jee-Fu Huang; Chia-Yen Dai; Chi-Kung Ho; Wan-Long Chuang; Ming-Lung Yu
• Keywords: Cross-sectional study

Fatty liver disease (FLD) is associated with several metabolic derangements. We conducted a retrospective cross-sectional and longitudinal study to evaluate the role of FL severity in the risk of new-onset and co-existing hypertension (HTN) and diabetes mellitus (DM).The cross-sectional cohort consisted of 41,888 adults who received health checkups in a tertiary hospital of Taiwan from 1999 to 2013. Of them, 34,865 without HTN and/or DM at baseline and within 1 year after enrollment were included as a longitudinal cohort (mean, 6.45 years for HTN; 6.75 years for DM). FL severity based on the degree of hepatic steatosis was assessed by ultrasound sonography.In cross-sectional cohort, 22,852 (54.6%) subjects had FL (18,203 [43.46%] mild FL and 4,649 [11.10%] moderate/severe FL); 13.5% (n = 5668) had HTN; and 3.4% (n = 1411) had DM. Moderate/severe FL and mild FL had significantly higher risks of existing HTN (adjusted odds ratio/95% confidence interval [CI] 1.59/1.43-1.77 and 1.22/1.13-1.32, respectively). In longitudinal cohort, 3,209 and 822 subjects developed new-onset HTN and DM, respectively (annual incidence, 14.3 and 3.5 per 1000 person-years; 10-year cumulative incidence, 14.35% and 3.89%, respectively). Moderate/severe and mild FL had significantly higher risks of new-onset HTN (adjusted hazard ratio [aHR]/CI 1.54/1.34-1.77 and 1.26/1.16-1.37, respectively) and DM (aHR/CI 5.88/4.44-7.81 and 3.22/2.56-4.07, respectively). Resolved FL during follow-up decreased the risk of HTN and/or DM.Patients with FL are at high risk of prevalent and incident HTN and/or DM. The risk increases with the severity of FL.