Commentary
Liver stiffness, as assessed by vibration-controlled transient elastography (VCTE), correlates with hepatic fibrosis, an important predictor of liver-related and all-cause mortality. Although liver fat is associated with cardiovascular risk factors, the association between hepatic fibrosis and cardiovascular risk factors is less clear.
The authors performed vibration-controlled transient elastography, assessing controlled attenuation parameter and liver stiffness measurement in 3,276 Framingham Heart Study adult participants presenting for a routine study visit.
In this large, community-based sample of middle-aged and older adults unselected for liver disease, 8.8% of participants, a substantial minority, exceeded the threshold of potentially clinically significant hepatic fibrosis. Hepatic fibrosis was associated with multiple obesity-, glucose-, vascular- and cholesterol-related traits. Hepatic fibrosis remained significantly associated with obesity-related traits, hypertension, low HDL-cholesterol and, most strongly, with diabetes, even after accounting for controlled attenuation parameter which suggests an association between hepatic fibrosis and cardiometabolic disease over and above the association with hepatic steatosis.
