Association between liver fat level and risk of hypertension: evidence from a Chinese health examination dataset

Author:

Sun Yongbing1,Qi Xin2,Wang Xuan3,Lin Xinbei1,Zhou Yang1,Du Yawei4,Liu Ao1,Lv Xue5,Zhou Jing6,Li Zhonglin1,Wu Xiaoling7,Zou Zhi1,Dou Shewei1,Zhang Michael8,Zhu Jiadong9,Shang Feifei9,Li Fengli10,Hu Yangxi10,Li Hao11,Li Yongli9

Affiliation:

1. Department of Medical Imaging, People's Hospital of Zhengzhou University

2. Department of Medical Imaging, Henan Provincial People's Hospital, Xinxiang Medical College

3. Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University

4. Department of Medical Imaging, Henan Provincial People's Hospital, Henan University People's Hospital

5. Henan Provincial People's Hospital

6. Henan Provincial Research Center of Clinical Medicine of Nephropathy

7. Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan, China

8. Sevenoaks Health Management Center, Canada-Canada Institute of Health Engineering, University of Manitoba, Winnipeg, Canada

9. Department of Health Management, Henan Provincial People's Hospital, Chronic Health Management Laboratory

10. Department of Bariatric Metabolic Surgery, Central Hospital of Zhengzhou University, Zhengzhou

11. Fuwaihua Central Vascular Disease Hospital, Zhengzhou, Henan, China

Abstract

Background: Hypertension development is predominantly influenced by inflammation, excessive fat deposition, and metabolic irregularities. Among these factors, liver fat accumulation is a critical metabolic disorder. However, the quantification of liver fat levels and its associated risk for hypertension incidence remain ambiguous. This project is designed to explore the association between liver fat levels and the risk of hypertension in a healthy population. Methods: This cross-sectional study involved 4955 participants from the Health Management Center at Henan Provincial People's Hospital who were surveyed between February 2020 and February 2023. Participants were categorized into four groups based on liver fat quartiles. Subgroup analyses, restricted cubic spline regression models, and logistic regression were utilized to assess the association between liver fat levels and hypertension risk. The relationships between liver fat levels and inflammatory markers were examined using multiple linear regression models. Additionally, a mediation analysis was conducted to explore the role of inflammatory factors in the relationship between liver fat and hypertension risk. Results: Participants with hypertension exhibited greater liver fat levels than did those without hypertension. An increased risk of hypertension was associated with elevated liver fat levels, even after adjusting for other covariates [Q4 vs. Q1 in model II: odds ratio (OR = 1.28), 95% confidence interval (CI) = 1.04–1.59, P = 0.022; P for trend = 0.039]. A nonlinear relationship was observed between liver fat level and hypertension risk, with a notable increase in hypertension risk occurring at liver fat levels greater than 8.65%. Additionally, a positive correlation was found between inflammatory markers and liver fat levels. A mediation effect of 4.76% was noted, linking hypertension risk and liver fat levels through neutrophils. Conclusion: Liver fat levels exceeding 8.65% significantly elevated the risk of hypertension. Inflammatory factors serve as crucial mediators of the relationship between liver fat and hypertension.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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