Abstract 15983: Association of Cardiovascular Health With Nonalcoholic Fatty Liver Disease in American Adults

Abstract

Introduction: Nonalcoholic fatty liver disease (NAFLD) affects 1 in 3 Americans and is associated with an increased cardiovascular disease (CVD) risk, however the association of cardiovascular health (CVH), quantified by the AHA Life’s Essential 8 (LE8) score, and NAFLD is unclear. Hypothesis: CVH has an inverse association with NAFLD quantified using vibration-controlled transient elastography in a nationally representative sample from the NHANES 2017-2020 cycle. Methods: Individuals aged <20 years, with pregnancy, viral, autoimmune, or alcoholic liver disease were excluded. The mean value of the 8 components (each scored from 0 to 100) was calculated to estimate the LE8 score. Ideal, intermediate, and poor CVH were categorized based on LE8 score of ≥80, 50-79, and <50, respectively. A median controlled attenuation parameter of >288 decibels per meter and median liver stiffness of >8.6 kilopascals were used to define hepatic steatosis and fibrosis, respectively. A survey weighted logistic regression model was used to assess the association of CVH with liver steatosis and fibrosis. Results: The final study population included 8,974 participants, corresponding to a weighted sample of 230,700,687 with a mean age of 47.7 years, SE 0.76 and 51.3% women. The mean LE8 score was 68.4, SE 0.46. 35.6% (95% CI 33.4-37.8) participants had hepatic steatosis and 8.4% (95% CI 6.8-10.0) had hepatic fibrosis. Among those with poor CVH, the proportion of individuals with hepatic fibrosis (22.4% vs. 2.0%) and steatosis (67.4% vs. 11.9%) was higher as compared to those with ideal CVH (Figure). Participants with ideal CVH had 94% lower odds of hepatic steatosis and 86% lower odds of hepatic fibrosis as compared to those with poor CVH. Conclusions: CVH is independently associated with prevalent NAFLD among American adults. LE8 score may be considered an index of metabolic liver health and not just cardiovascular health.