Liver steatosis and fibrosis markers’ association with cardiovascular and renal damage in Japanese adults: the TMM BirThree cohort study

Introduction and Objectives: Patients with non-alcoholic fatty liver disease (NAFLD) are at risk for cardiovascular and chronic kidney diseases. Liver steatosis and fibrosis were assessed using the fatty liver index and fibrosis-4 index, respectively. This study aimed to examine the association between these two parameters in patients with atherosclerosis and chronic kidney disease. Materials and Methods: The two parameters were calculated for 11,867 adults who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Intima-media thickness and estimated glomerular filtration rate were also measured. Logistic regression models were used to estimate the odds ratios (OR). Results: Overall, 4257 (35.9%) and 4733 (39.9%) participants had a higher probability of liver steatosis and fibrosis, respectively. The adjusted OR of higher fatty liver index compared to lower fatty liver index for atherosclerosis and chronic kidney disease were 0.98 (95% confidence interval [CI], 0.77–1.24) and 1.79 (95% CI, 1.19–2.69), and those of higher FIB-4 compared to lower FIB-4 were 1.03 (95% CI, 0.82–1.30) and 0.79 (95% CI, 0.52–1.19) for atherosclerosis and chronic kidney disease, respectively. Conclusions: A higher FLI was associated with CKD independent of other risk factors. Further research is required to identify the causal relationship between liver fat accumulation and CKD