Abstract 12340: Association of Liver Enzymes With Incident Cardiovascular Disease Events and All-Cause Mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Introduction: Metabolic associated fatty liver disease (MAFLD) is a significant contributor to chronic liver disease on a global scale, encompassing a broad range of systemic impacts, including an increased risk of cardiovascular disease (CVD). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are commonly utilized indicators of liver injury in this context. Despite the high prevalence of MAFLD among Hispanic/Latino populations, there is a scarcity of research focusing on this specific demographic. Aim: To investigate the relationship between liver disease, incident CVD, and mortality in a representative Hispanic/Latino population, using non-invasive markers. Methods: A total of 14,149 participants recruited between 2008-2011 in HCHS/SOL aged 18-74 years with no pre-existing CVD at study baseline were included in this study. The outcome of interest was a composite of adjudicated incident CVD and all-cause mortality. Participants who had liver function tests (LFTs) AST > 37 IU/mL or ALT > 40 IU/mL for men, and AST or ALT > 31 IU/mL for women were classified as having elevated LFTs. MAFLD was defined as a fatty liver index score >60 and: type 2 diabetes, body mass index>25 kg/m 2 or at least two metabolic risk abnormalities. Survey-weighted cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for our composite outcome by elevated LFTs. Interaction terms assessed the relationship between elevated LFTs and MAFLD. Results: The study population was 40 years old on average, 53.4% female and had 403 weighted CVD and all-cause mortality events. Elevated LFTs and MAFLD alone were not associated with incident CVD and all-cause mortality (HR: 1.24; CI: 0.89-1.71). MAFLD modified the relationship between elevated LFTs and CVD (P=0.04). Among those with MAFLD, elevated LFTs were not associated with CVD (HR: 1.01; CI:0.70-1.46), but among those without MAFLD, elevated LFTs were associated with CVD (HR: 2.05; CI:1.17-3.58). Conclusions: Among Hispanic/Latinos without MAFLD, elevated LFTs were associated with CVD and all-cause mortality. Additional research is needed to elucidate the relationship between liver disease and CVD in the Hispanic/Latino population.