Asociación entre hígado graso no alcohólico, riesgo metabólico y vascular / Association between non alcoholic fatty liver disease, metabolic and vascular risk

ANTECEDENTES: La esteatosis hepática es un problema de salud pública de incidencia y prevalencia crecientes en nuestra sociedad. OBJETIVO: Determinar si la esteatosis hepática, medida mediante el Fatty Liver Index (FLI), se relaciona con el riesgo metabólico y vascular y, de ser así, identificar qué factor clínico-metabólico explica el mayor riesgo vascular de estos pacientes. MÉTODOS: Estudio transversal que incluye una muestra de 531 varones que acudieron a la unidad de chequeos de la Clínica Universitaria de Navarra. Se determinó el grado de esteatosis mediante el FLI. El riesgo metabólico fue evaluado mediante una escala basada en determinaciones de HDL, LDL, triglicéridos, glucemia, HOMA-IR, índice neutrófilo/linfocitario y presión sistólica; el riesgo vascular, mediante la presencia de placas ateromatosas en carótidas y/o femorales. La asociación dosis-respuesta entre el FLI y ambos riesgos se analizó mediante modelos no paramétricos (splines) y regresión logística. RESULTADOS: La muestra estudiada presenta una edad media de 52,70años, con el 49,3% de ellos presentando un FLI≥60, el 33,6% con síndrome metabólico y el 43,9% con placas ateromatosas en carótidas o femorales. La relación entre el FLI y el riesgo metabólico y vascular fue lineal (metabólico: valor de p no lineal=0,097; valor de p lineal <0,001; vascular: valor de p no lineal=1,000; valor de p lineal=0,028). Por cada 10unidades de incremento del FLI la odds de presentar placas de ateroma aumentaba en un 9,7% (OR=1,097; intervalo de confianza al 95%: 1,010-1,191). Al ajustar por trigliceridemia la asociación desaparecía (OR=1,001). CONCLUSIONES: Los pacientes con esteatosis hepática presentan un mayor riesgo metabólico y vascular. El mayor riesgo vascular está asociado con el nivel de triglicéridos. A nivel clínico, este estudio sugiere que estos pacientes podrían beneficiarse del tratamiento de la hipertrigliceridemia

BACKGROUND: Hepatic steatosis is a public health problem with increased incidence and prevalence. OBJECTIVE: To determine whether the liver steatosis, as measured by the Fatty Liver Index (FLI), is related to metabolic risk and vascular factors and, if so, to identify the clinical-metabolic factor that explains the higher vascular risk. METHODS: Cross-sectional study including a sample of 531 men who came to the University of Navarra Clinic Check-up Unit. The degree of steatosis was determined by the FLI. The metabolic risk was assessed using a scale based on determinations of HDL, LDL, triglycerides, blood glucose, HOMA-IR, neutrophil/lymphocyte index, and systolic blood pressure. The vascular risk was assessed by the presence of carotid and/or femoral atheromatous plaques. The dose-response association between FLI and both risks was analysed using non-parametric models (splines) and logistic regression. RESULTS: The sample studied had a mean age of 52.70years, with 49.3% having an FLI ≥60, as well as 33.6% with metabolic syndrome, and 43.9% with carotid and/or femoral atheromatous plaques. The relationship between FLI and metabolic risk and vascular was linear (metabolic: non-linear P=.097; linear P<.001; vascular: non-linear P=1.000; linear P=.028). For every 10 units of increase in FLI, the odds of presenting with atheroma plaques increased by 9.7% (OR=1.097; 95% confidence interval 1.010-1.191). When adjusting for triglyceridaemia, the association disappeared (OR=1.001). CONCLUSIONS: Patients with fatty liver disease had an increased metabolic and vascular risk. The increased vascular risk is associated with the triglyceride level. On a clinical level, this study suggests that these patients could benefit from treatment of hypertriglyceridaemia

Association between non alcoholic fatty liver disease, metabolic and vascular risk. / Asociación entre hígado graso no alcohólico, riesgo metabólico y vascular.

BACKGROUND: Hepatic steatosis is a public health problem with increased incidence and prevalence OBJECTIVE: To determine whether the liver steatosis, as measured by the Fatty Liver Index (FLI), is related to metabolic risk and vascular factors and, if so, to identify the clinical-metabolic factor that explains the higher vascular risk. METHODS: Cross-sectional study including a sample of 531 men who came to the University of Navarra Clinic Check-up Unit. The degree of steatosis was determined by the FLI. The metabolic risk was assessed using a scale based on determinations of HDL, LDL, triglycerides, blood glucose, HOMA-IR, neutrophil/lymphocyte index, and systolic blood pressure. The vascular risk was assessed by the presence of carotid and/or femoral atheromatous plaques. The dose-response association between FLI and both risks was analysed using non-parametric models (splines) and logistic regression. RESULTS: The sample studied had a mean age of 52.70years, with 49.3% having an FLI ≥60, as well as 33.6% with metabolic syndrome, and 43.9% with carotid and/or femoral atheromatous plaques. The relationship between FLI and metabolic risk and vascular was linear (metabolic: non-linear P=.097; linear P<.001; vascular: non-linear P=1.000; linear P=.028). For every 10 units of increase in FLI, the odds of presenting with atheroma plaques increased by 9.7% (OR=1.097; 95% confidence interval 1.010-1.191). When adjusting for triglyceridaemia, the association disappeared (OR=1.001). CONCLUSIONS: Patients with fatty liver disease had an increased metabolic and vascular risk. The increased vascular risk is associated with the triglyceride level. On a clinical level, this study suggests that these patients could benefit from treatment of hypertriglyceridaemia.