Nonalcoholic fatty liver disease and risk of incident young-onset hypertension: Effect modification by sex

Although nonalcoholic fatty liver disease (NAFLD) and hypertension are increasingly common among young adults, it is uncertain if NAFLD affects incidence of young-onset hypertension, and if the association is modified by sex. We investigated potential effect modification by sex on the association be...

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Veröffentlicht in:Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2023-08, Vol.33 (8), p.1608-1616
Hauptverfasser: Kim, Yejin, Chang, Yoosoo, Ryu, Seungho, Park, Soyoung, Cho, Yoosun, Sohn, Won, Kang, Jeonggyu, Wild, Sarah H., Byrne, Christopher D.
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container_end_page 1616
container_issue 8
container_start_page 1608
container_title Nutrition, metabolism, and cardiovascular diseases
container_volume 33
creator Kim, Yejin
Chang, Yoosoo
Ryu, Seungho
Park, Soyoung
Cho, Yoosun
Sohn, Won
Kang, Jeonggyu
Wild, Sarah H.
Byrne, Christopher D.
description Although nonalcoholic fatty liver disease (NAFLD) and hypertension are increasingly common among young adults, it is uncertain if NAFLD affects incidence of young-onset hypertension, and if the association is modified by sex. We investigated potential effect modification by sex on the association between NAFLD and incident hypertension in young adults (
doi_str_mv 10.1016/j.numecd.2023.04.021
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We investigated potential effect modification by sex on the association between NAFLD and incident hypertension in young adults (&lt;40 years). This cohort study comprised 85,789 women and 67,553 men aged &lt;40 years without hypertension at baseline. Hepatic steatosis was assessed by liver ultrasound and classified as mild or moderate/severe. Hypertension was defined as blood pressure (BP) ≥130/80 mmHg; self-reported history of physician-diagnosed hypertension; or current use of BP-lowering medications. Cox proportional hazard models were used to estimate hazard ratios (HRs; 95% confidence intervals [CIs]) for incident hypertension by NAFLD status (median follow-up 4.5 years). A total of 25,891 participants developed incident hypertension (incidence rates per 103 person-years: 15.6 for women and 63.5 for men). Multivariable-adjusted HRs (95% CIs) for incident hypertension comparing no NAFLD (reference) with mild or moderate/severe NAFLD were 1.68 (1.56–1.80) and 1.83 (1.60–2.09) for women and 1.21 (1.17–1.25) and 1.23 (1.17–1.30) for men, respectively. Stronger associations were consistently observed between NAFLD and incident hypertension in women, regardless of obesity/central obesity (all p-values for interaction by sex &lt;0.001). NAFLD is a potential risk factor for young-onset hypertension with a relatively greater impact in women and in those with more severe hepatic steatosis. [Display omitted] •Nonalcoholic fatty liver disease (NAFLD) increases risks of young-onset hypertension.•The association between NAFLD and young-onset hypertension was independent of obesity.•The presence of NAFLD attenuates protection against hypertension in young women.•Sex-specific multisystem consequences of NAFLD in younger people deserves more attention.</description><identifier>ISSN: 0939-4753</identifier><identifier>EISSN: 1590-3729</identifier><identifier>DOI: 10.1016/j.numecd.2023.04.021</identifier><identifier>PMID: 37357078</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cohort Studies ; Cohort study ; Female ; Humans ; Hypertension - diagnosis ; Hypertension - epidemiology ; Male ; Non-alcoholic Fatty Liver Disease - diagnostic imaging ; Non-alcoholic Fatty Liver Disease - epidemiology ; Nonalcoholic fatty liver disease ; Obesity ; Risk Factors ; Sex difference ; Sex dimorphism ; Young-onset hypertension</subject><ispartof>Nutrition, metabolism, and cardiovascular diseases, 2023-08, Vol.33 (8), p.1608-1616</ispartof><rights>2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University</rights><rights>Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. 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Multivariable-adjusted HRs (95% CIs) for incident hypertension comparing no NAFLD (reference) with mild or moderate/severe NAFLD were 1.68 (1.56–1.80) and 1.83 (1.60–2.09) for women and 1.21 (1.17–1.25) and 1.23 (1.17–1.30) for men, respectively. Stronger associations were consistently observed between NAFLD and incident hypertension in women, regardless of obesity/central obesity (all p-values for interaction by sex &lt;0.001). NAFLD is a potential risk factor for young-onset hypertension with a relatively greater impact in women and in those with more severe hepatic steatosis. [Display omitted] •Nonalcoholic fatty liver disease (NAFLD) increases risks of young-onset hypertension.•The association between NAFLD and young-onset hypertension was independent of obesity.•The presence of NAFLD attenuates protection against hypertension in young women.•Sex-specific multisystem consequences of NAFLD in younger people deserves more attention.</description><subject>Cohort Studies</subject><subject>Cohort study</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Male</subject><subject>Non-alcoholic Fatty Liver Disease - diagnostic imaging</subject><subject>Non-alcoholic Fatty Liver Disease - epidemiology</subject><subject>Nonalcoholic fatty liver disease</subject><subject>Obesity</subject><subject>Risk Factors</subject><subject>Sex difference</subject><subject>Sex dimorphism</subject><subject>Young-onset hypertension</subject><issn>0939-4753</issn><issn>1590-3729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhq0KRJfCP0DIRy4J_lwnHJBQ1RakCi69W449br0k9mI7Ffn3uNrCkdNIo-edV_Mg9I6SnhK6_3jo47qAdT0jjPdE9ITRM7SjciQdV2x8gXZk5GMnlOTn6HUpB0K4Ily8QudccamIGnbo8D1FM9v0kOZgsTe1bngOj5CxCwVMAWyiwzmUnzh5HKINDmLFW1rjfZdigYoftiPkCrGEFD_hK-_BVrwkF3ywprYlnjZc4Pcb9NKbucDb53mB7q6v7i6_drc_br5dfrntrCBD7Rgd1bTnwlNH93Qwk-Gs7ZgwklCYRunYAGBBSpBW-XE_DNL7aWq9xo-CX6APp7PHnH6tUKpeQrEwzyZCWotmAxsVEYTQhooTanMqJYPXxxwWkzdNiX6SrA_6JFk_SdZE6Ca5xd4_N6zTAu5f6K_VBnw-AdDefAyQdbEBogUXcpOjXQr_b_gDMayRig</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Kim, Yejin</creator><creator>Chang, Yoosoo</creator><creator>Ryu, Seungho</creator><creator>Park, Soyoung</creator><creator>Cho, Yoosun</creator><creator>Sohn, Won</creator><creator>Kang, Jeonggyu</creator><creator>Wild, Sarah H.</creator><creator>Byrne, Christopher D.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3284-2715</orcidid><orcidid>https://orcid.org/0000-0001-6322-7753</orcidid><orcidid>https://orcid.org/0000-0002-6945-9050</orcidid></search><sort><creationdate>202308</creationdate><title>Nonalcoholic fatty liver disease and risk of incident young-onset hypertension: Effect modification by sex</title><author>Kim, Yejin ; 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We investigated potential effect modification by sex on the association between NAFLD and incident hypertension in young adults (&lt;40 years). This cohort study comprised 85,789 women and 67,553 men aged &lt;40 years without hypertension at baseline. Hepatic steatosis was assessed by liver ultrasound and classified as mild or moderate/severe. Hypertension was defined as blood pressure (BP) ≥130/80 mmHg; self-reported history of physician-diagnosed hypertension; or current use of BP-lowering medications. Cox proportional hazard models were used to estimate hazard ratios (HRs; 95% confidence intervals [CIs]) for incident hypertension by NAFLD status (median follow-up 4.5 years). A total of 25,891 participants developed incident hypertension (incidence rates per 103 person-years: 15.6 for women and 63.5 for men). Multivariable-adjusted HRs (95% CIs) for incident hypertension comparing no NAFLD (reference) with mild or moderate/severe NAFLD were 1.68 (1.56–1.80) and 1.83 (1.60–2.09) for women and 1.21 (1.17–1.25) and 1.23 (1.17–1.30) for men, respectively. Stronger associations were consistently observed between NAFLD and incident hypertension in women, regardless of obesity/central obesity (all p-values for interaction by sex &lt;0.001). NAFLD is a potential risk factor for young-onset hypertension with a relatively greater impact in women and in those with more severe hepatic steatosis. [Display omitted] •Nonalcoholic fatty liver disease (NAFLD) increases risks of young-onset hypertension.•The association between NAFLD and young-onset hypertension was independent of obesity.•The presence of NAFLD attenuates protection against hypertension in young women.•Sex-specific multisystem consequences of NAFLD in younger people deserves more attention.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37357078</pmid><doi>10.1016/j.numecd.2023.04.021</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3284-2715</orcidid><orcidid>https://orcid.org/0000-0001-6322-7753</orcidid><orcidid>https://orcid.org/0000-0002-6945-9050</orcidid><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals Complete
subjects Cohort Studies
Cohort study
Female
Humans
Hypertension - diagnosis
Hypertension - epidemiology
Male
Non-alcoholic Fatty Liver Disease - diagnostic imaging
Non-alcoholic Fatty Liver Disease - epidemiology
Nonalcoholic fatty liver disease
Obesity
Risk Factors
Sex difference
Sex dimorphism
Young-onset hypertension
title Nonalcoholic fatty liver disease and risk of incident young-onset hypertension: Effect modification by sex
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