Chambergo-Michilot Diego, Rodrigo-Gallardo Paola K, Huaman Mariella R, Vasquez-Chavesta Angie Z, Salinas-Sedo Gustavo, Toro-Huamanchumo Carlos J
Universidad Científica del Sur, Lima, Peru.
Hospital Docente Las Mercedes, Chiclayo, Peru.
Clin Exp Gastroenterol. 2023 Aug 14;16:129-136. doi: 10.2147/CEG.S402498. eCollection 2023.
Cardiovascular diseases are responsible for the majority of deaths resulting from non-alcoholic fatty liver disease (NAFLD). NAFLD is associated with hypertension and this is a key predictor of severe liver outcomes and an indicator of nonspecific portal fibrosis.
To assess the association between hypertension and NAFLD severity.
We conducted a secondary analysis of data from Peruvian adults with obesity and NAFLD who attended a Peruvian bariatric center. The severity of NAFLD was assessed using the Fatty Liver Inhibition of Progression algorithm / Steatosis, Activity and Fibrosis score. Hypertension was determined by either being recorded in the medical records or if the patient had a systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg. To evaluate the association of interest, we calculated crude and adjusted prevalence ratios (aPR) using Poisson generalized linear models with logarithmic link function and robust variances. For the multivariable models, we adjusted for age, sex, physical activity and smoking.
Our study included 234 participants. The prevalence of hypertension was 19.2%, while the prevalence of severe NAFLD was 46.2%. After adjusting for confounders, the prevalence of hypertension was found to be significantly higher in the severe NAFLD group compared to the non-severe group (aPR = 1.33; 95% CI: 1.03-1.74). When stratified by the presence of metabolic syndrome (MetS), the association remained significant only in the group without MetS (aPR = 1.80; 95% CI: 1.05-3.11).
We found an association between hypertension and severe NAFLD in adults with obesity, particularly in those without MetS.
心血管疾病是导致非酒精性脂肪性肝病（NAFLD）死亡的主要原因。NAFLD与高血压相关，这是严重肝脏结局的关键预测因素和非特异性门静脉纤维化的指标。
评估高血压与NAFLD严重程度之间的关联。
我们对秘鲁一家减肥中心的肥胖和NAFLD成年秘鲁人数据进行了二次分析。使用脂肪肝进展抑制算法/脂肪变性、活动和纤维化评分评估NAFLD的严重程度。高血压通过病历记录确定，或者如果患者收缩压≥140 mmHg或舒张压≥90 mmHg。为了评估感兴趣的关联，我们使用具有对数链接函数和稳健方差的泊松广义线性模型计算了粗患病率和调整患病率比（aPR）。对于多变量模型，我们对年龄、性别、身体活动和吸烟进行了调整。
我们的研究包括234名参与者。高血压患病率为19.2%，而严重NAFLD患病率为46.2%。在调整混杂因素后，发现严重NAFLD组的高血压患病率显著高于非严重组（aPR = 1.33；95% CI：1.03 - 1.74）。按代谢综合征（MetS）的存在进行分层时，该关联仅在无MetS的组中仍然显著（aPR = 1.80；95% CI：1.05 - 3.11）。
我们发现肥胖成年人中高血压与严重NAFLD之间存在关联，尤其是在无MetS的成年人中。
