Abstract P359: Non-Alcoholic Fatty Liver Disease Severity is Associated With Aortic Stiffness Independently From Adiposity and Cardiovascular Risk Factors

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of conditions closely related to adiposity, hypertension, diabetes, and dyslipidemia. NAFLD has been consistently associated with adverse-health cardiovascular outcomes and subclinical atherosclerosis markers. However, there are contradictory findings (most of them with few participants) of the relationship between NAFLD and aortic stiffness: ones describing as an independent association, others as an association mediated by traditional cardiovascular risk factors. Hypothesis: NAFLD presence and severity is associated independently with aortic stiffness. Methods: We addressed this question among civil servants aged 35 to 74 years, 54% of them, women, and free of cardiovascular disease during the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The presence and severity of NAFLD were assessed by ultrasound hepatic attenuation validated with computerized tomography. Aortic stiffness was measured by the carotid-femoral pulse wave velocity (cf-PWV) by a non-invasive certified device (Complior SP). We applied ANOVA to compare the estimated cf-PWVs means and 95% Confidence according to NAFLD categories. These values were adjusted for age, sex, race, waist circumference, diabetes, dyslipidemia, high sensitivity C reactive protein, mean arterial pressure, and use of anti-hypertensive drugs. Results: Among 7,156 participants, 63.5% did not have NAFLD, 22.7% were classified as mild NAFLD, 11.7% as moderate, and 2.1% as severe. An overview of crude means from the absence of NAFLD to severe NAFLD there were slightly older individuals, a higher proportion of men, lower frequency of current smokers, and people with at least or hypertension or diabetes or dyslipidemia. In the fully adjusted analysis, the cf-PWV (m/s) values were similar among subjects with absence of NAFLD [9.27 (9.18 to 9.36)] compared with the presence of either grade of NAFLD [9.24 (9.15, 9.32)(p=0.285)]. However, there was a significant difference between cf-PWV for people without NAFLD [9.23 (9.15, 9.32)] compared with subjects with severe NAFLD [9.51 (9.31, 9.70). A significant high cf-PWV was significant thru NAFLD categories. (p-value for trend=0.045)]. There was no effect modification of this association across age strata, sex, race, waist circumference and body mass index strata, and presence of hypertension, diabetes, and dyslipidemia. Conclusion: In a population of individuals free of cardiovascular disease, NAFLD severity was associated with aortic stiffness regardless of adiposity and the traditional cardiometabolic risk factors.