Fatty liver index is associated to pulse wave velocity in healthy subjects: Data from the Brisighella Heart Study

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is associated to increased risk of cardiovascular disease. Our aim was to evaluate association of indexes of fatty liver with arterial stiffness (AS). Methods: We analyzed data of adult volunteers visited during the last Brisighella survey. We evaluated the Pulse Wave Velocity (PWV) and the following non-invasive indexes of liver steatosis: Fatty Liver Index (FLI), Lipid Accumulation Product (LAP), Hepatic Steatosis Index (HSI). We compared patients according to the risk of NonAlcoholic Steatohepatitis (NASH): low-risk (BMI < 28 and no diabetes), intermediate-risk (BMI >= 28 or diabetes), high-risk (BMI >= 28 and diabetes). Multiple Linear Regression analysis was assessed for predictors of AS. Results: We studied 1731 volunteers. In subjects with low metabolic risk, HSI (RR = 0.138, 95% CI 0.105-0.170, p < 0.001), FLI (RR = 0.024, 95% CI 0.016-0.032, p < 0.001), LAP (RR = 0.014, 95% CI 0.008-0.020, p < 0.001) and Serum Uric Acid (RR = 0.150, 95% CI 0.024-0.275, p = 0.019) were significant predictors of AS. HSI and FLI emerged as predictors of PWV in intermediate risk group (RR = 0.116, 95% CI 0.071-0.160, p < 0.001; RR = 0.010, 95% CI 0.001-0.020, p = 0.041). In volunteers with high risk, FLI and Uric Acid were related to PWV (RR = 0.049, 95% CI 0.011-0.087, p = 0.013; RR = 0.632, 95% CI 0.222-1.041, p = 0.003). Conclusion: Fatty liver indirect indexes were associated to AS in subjects with different metabolic risk profiles.