Peripheral Artery Disease and Risk of Fibrosis Deterioration in Nonalcoholic Fatty Liver Disease: A Prospective Investigation.

Wen ZHU; Chan Juan DENG; Li Ping XUAN; Hua Jie DAI; Zhi Yun ZHAO; Tian Ge WANG; Mian LI; Jie Li LU; Yu XU; Yu Hong CHEN; Wei Qing WANG; Yu Fang BI; Min XU

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Peripheral Artery Disease and Risk of Fibrosis Deterioration in Nonalcoholic Fatty Liver Disease: A Prospective Investigation.

Author: Wen ZHU ¹ ; Chan Juan DENG ¹ ; Li Ping XUAN ¹ ; Hua Jie DAI ¹ ; Zhi Yun ZHAO ¹ ; Tian Ge WANG ¹ ; Mian LI ¹ ; Jie Li LU ¹ ; Yu XU ¹ ; Yu Hong CHEN ¹ ; Wei Qing WANG ¹ ; Yu Fang BI ¹ ; Min XU ¹
Author Information

1. State Key Laboratory of Medical Genomics, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Publication Type:Journal Article
Keywords: Ankle-brachial index; Fibrosis deterioration; Insulin resistance; NAFLD fibrosis score; Nonalcoholic fatty liver disease
MeSH: Adult; Aged; Aged, 80 and over; Ankle Brachial Index; China; epidemiology; Female; Humans; Liver Cirrhosis; epidemiology; etiology; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; epidemiology; etiology; Peripheral Arterial Disease; complications; Prevalence; Prospective Studies; Risk Factors
From: Biomedical and Environmental Sciences 2020;33(4):217-226
CountryChina
Language:English
Abstract: Objective:Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Peripheral artery disease (PAD) and liver fibrosis share many common metabolic dysfunctions. We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.
Methods:The study recruited 1,610 NAFLD patients aged ≥ 40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015. Fibrosis deterioration was defined as the NAFLD fibrosis score (NFS) status increased to a higher category at the follow-up visit. PAD was defined as an ankle-brachial index of < 0.90 or > 1.40.
Results:During an average of 4.3 years' follow-up, 618 patients progressed to a higher NFS category. PAD was associated with 92% increased risk of fibrosis deterioration [multivariable-adjusted odds ratio ( ): 1.92, 95% confidence interval ( ): 1.24, 2.98]. When stratified by baseline NFS status, the for progression from low to intermediate or high NFS was 1.74 (95% : 1.02, 3.00), and progression from intermediate to high NFS was 2.24 (95% : 1.05, 4.80). There was a significant interaction between PAD and insulin resistance (IR) on fibrosis deterioration ( for interaction = 0.03). As compared with non-PAD and non-IR, the coexistence of PAD and IR was associated with a 3.85-fold (95% : 2.06, 7.18) increased risk of fibrosis deterioration.
Conclusion:PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients, especially in those with IR. The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.