Hypertension and Histopathology Severity of Non-Alcoholic Fatty Liver Disease Among Adults with Obesity: A Cross-Sectional Study

Abstract

Diego Chambergo-Michilot,1,* Paola K Rodrigo-Gallardo,2 Mariella R Huaman,3,* Angie Z Vasquez-Chavesta,4 Gustavo Salinas-Sedo,5 Carlos J Toro-Huamanchumo6,7,* 1Universidad Científica del Sur, Lima, Peru; 2Hospital Docente Las Mercedes, Chiclayo, Peru; 3Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru; 4Facultad de Medicina Humana, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Peru; 5Unidad de Investigación Multidisciplinaria, Clínica Avendaño, Lima, Peru; 6Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; 7OBEMET Centro de Obesidad y Salud Metabólica, Lima, Peru*These authors contributed equally to this workCorrespondence: Carlos J Toro-Huamanchumo, Universidad San Ignacio de Loyola, Av. la Fontana 550, La Molina, Lima, 15024, Peru, Tel + 51944942888, Email [email protected]: 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.Aim: To assess the association between hypertension and NAFLD severity.Methods: 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.Results: 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).Conclusion: We found an association between hypertension and severe NAFLD in adults with obesity, particularly in those without MetS.Keywords: non-alcoholic fatty liver disease, hypertension, obesity

Keywords

• non-alcoholic fatty liver disease
• hypertension
• obesity