Jae Hyung Roh1, Jae Hyeong Park2, Hanbyul Lee3, Yong Hoon Yoon1, Minsu Kim1, Yong Giun Kim4, Gyung Min Park4, Jae Hwan Lee1, In Whan Seong1. 1. Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea. 2. Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea. jaehpark@cnu.ac.kr. 3. Department of Statistics, Kyungpook National University, Daegu, Korea. 4. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Abstract
BACKGROUND AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is an excessive accumulation of fat into the liver as a result of increased inflammation and insulin resistance. Although there can be common pathogenic mechanisms for NAFLD and hypertension associated with the development of cardiovascular diseases, little data are showing the association between NAFLD and hypertension in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver index (FLI), a surrogate marker of NAFLD, to predict the development of hypertension in healthy individuals. METHODS: We included 334,280 healthy individuals without known comorbidities who underwent the National Health check-ups in South Korea from 2009 to 2014. The association between the FLI and hypertension was analyzed using multivariate Cox proportional-hazards models. RESULTS: During a median of 5.2 years' follow-up, 24,678 subjects (7.4%) had new-onset hypertension. We categorized total subjects into quartile groups according to FLI (range: Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The incidence of hypertension was higher in subjects with the highest FLI than in those with the lowest FLI (Q4, 9,968 [11.9%] vs. Q1, 2,277 [2.7%]; p<0.001). There was a significant correlation between the highest FLI and an increased risk of new-onset hypertension (adjusted hazard ratio between Q4 and Q1, 2.330; 95% confidence interval, 2.218-2.448; p<0.001). FLI was significantly associated with an increased risk of new-onset hypertension regardless of baseline characteristics. CONCLUSIONS: Higher FLI was independently associated with increased risk of hypertension in a healthy Korean population.
BACKGROUND AND OBJECTIVES:Nonalcoholic fatty liver disease (NAFLD) is an excessive accumulation of fat into the liver as a result of increased inflammation and insulin resistance. Although there can be common pathogenic mechanisms for NAFLD and hypertension associated with the development of cardiovascular diseases, little data are showing the association between NAFLD and hypertension in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver index (FLI), a surrogate marker of NAFLD, to predict the development of hypertension in healthy individuals. METHODS: We included 334,280 healthy individuals without known comorbidities who underwent the National Health check-ups in South Korea from 2009 to 2014. The association between the FLI and hypertension was analyzed using multivariate Cox proportional-hazards models. RESULTS: During a median of 5.2 years' follow-up, 24,678 subjects (7.4%) had new-onset hypertension. We categorized total subjects into quartile groups according to FLI (range: Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The incidence of hypertension was higher in subjects with the highest FLI than in those with the lowest FLI (Q4, 9,968 [11.9%] vs. Q1, 2,277 [2.7%]; p<0.001). There was a significant correlation between the highest FLI and an increased risk of new-onset hypertension (adjusted hazard ratio between Q4 and Q1, 2.330; 95% confidence interval, 2.218-2.448; p<0.001). FLI was significantly associated with an increased risk of new-onset hypertension regardless of baseline characteristics. CONCLUSIONS: Higher FLI was independently associated with increased risk of hypertension in a healthy Korean population.