Untreated newly diagnosed essential hypertension is associated with nonalcoholic fatty liver disease in a population of a hypertensive center

Figures & data

Table 1 Characteristics of patients with and without nonalcoholic fatty liver disease

Variables	NAFLD patients (N=163)	Controls (N=77)	P-value
Age (years)	54±11	55±11	0.470
Male (%)	36.2	28.6	0.244
Waist circumference (cm)	103±12	88±11	<0.001
BMI (kg/m^2)	30±5.5	25.64±3.8	<0.001
Smoking (%)	27.1	23.5	0.584
eGFR (mL/min/1.73 m^2)	97±27	101±23	0.399
Hypertension (%)	65.6	46.8	0.008
Office SBP (mmHg)	149±17	145±16	0.070
Office DBP (mmHg)	90±11	88±10	0.160
24-hour mean SBP (mmHg)	131±12	126±12	0.002
24-hour mean DBP (mmHg)	80±9.50	78±9.11	0.104
Daytime mean SBP (mmHg)	136±13.04	131±12.87	0.006
Daytime mean DBP (mmHg)	85±10	83±9.8	0.182
Nighttime mean SBP (mmHg)	120±14.00	113.4±18.00	0.004
Nighttime mean DBP (mmHg)	71±11	69±10	0.284
Morning mean SBP (mmHg)	131±14	125±17	0.013
Morning mean DBP (mmHg)	81±11	79±11	0.153
White-coat hypertension (%)	20.9	26	0.435
AST (IU/L)	22±9.70	19.10±5.51	0.023
ALT (IU/L)	29.3±23	22.40±21	0.001
GGT (IU/L)	24.8±16.3	15.6±8.2	<0.001
ALP (IU/L)	97.41±105.44	81.33±47.23	0.238
CHOL (mg/dL)	217±39	210±42	0.243
LDL (mg/dL)	138±36	136±40	0.729
HDL (mg/dL)	56.34±19.85	63.60±17.36	0.011
TRIGL (mg/dL)	130±65	94±51	<0.001
Hs-CRP (mg/L)	1.32±2.32	0.84±1.29	0.057
GLU (mg/dL)	95.66±12.52	90.89±8.77	0.001

Notes: Noncontinuous variables are given as percentages. Continuous variables are presented as mean ± SD. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

Abbreviations: NAFLD, nonalcoholic fatty liver disease; BMI, body mass index; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast; SD, standard deviation.

Table 2 Variables associated with nonalcoholic fatty liver disease in whole sample

Variables	B	OR	95% CI	P-value
Bivariate analysis
Age (years)	−0.010	0.990	0.963–1.017	0.467
Sex (male)	0.349	1.418	0.787–2.555	0.245
Waist circumference (cm)	0.112	1.118	1.080–1.157	<0.001
BMI (kg/m^2)	0.237	1.267	1.162–1.383	<0.001
Smoking (yes)	0.188	1.207	0.618–2.359	0.582
eGFR (mL/min/1.73 m^2)a	−0.080	0.923	0.739–1.154	0.484
Hypertension (yes)	0.778	2.177	1.253–3.780	0.006
Office SBP (mmHg)b	1.055	2.872	0.403–3.320	0.074
Office DBP (mmHg)	0.018	1.018	0.993–1.044	0.161
24-hour mean SBP (mmHg)	0.037	1.037	1.013–1.063	0.003
24-hour mean DBP (mmHg)	0.025	1.026	0.995–1.057	0.106
Daytime mean SBP (mmHg)	0.031	1.032	1.009–1.055	0.006
Daytime mean DBP (mmHg)	0.019	1.019	0.991–1.048	0.183
Nighttime mean SBP (mmHg)	0.030	1.030	1.010–1.051	0.004
Nighttime mean DBP (mmHg)	0.015	1.015	0.988–1.042	0.285
Morning mean SBP (mmHg)	0.025	1.025	1.005–1.045	0.013
Morning mean DBP (mmHg)	0.019	1.019	0.993–1.046	0.153
White-coat hypertension (yes)	−0.225	0.798	0.491–1.297	0.463
AST (IU/L)	0.060	1.062	1.012–1.115	0.015
ALT (IU/L)	0.023	1.024	1.001–1.046	0.038
GGT (IU/L)	0.081	1.084	1.044–1.125	<0.001
ALP (IU/L)	0.004	1.004	0.998–1.009	0.248
CHOL (mg/dL)	0.004	1.004	0.997–1.012	0.243
LDL (mg/dL)	0.001	1.001	0.993–1.009	0.728
HDL (mg/dL)	−0.020	0.980	0.965–0.996	0.015
TRIGL (mg/dL)	0.014	1.014	1.007–1.021	<0.001
Hs-CRP (mg/L)c	0.563	1.756	0.978–3.152	0.060
GLU (mg/dL)	0.042	1.043	1.013–1.074	0.004
Multivariate logistic regressiona
BMI (kg/m^2)	0.203	1.224	1.079–1.390	0.002
Hypertension (yes)	1.276	3.584	1.274–10.076	0.016
GGT (IU/L)	0.046	1.047	0.998–1.099	0.060

Notes: Odds ratio and 95% CI adjusted by office SBP, AST, and all covariables with P<0.100 in bivariate analysis. BMI and waist circumference were not included in the same model because they are continuous variables with a correlation coefficient higher than 0.7. The same applies to 24-hour mean SBP and daytime mean SBP, 24-hour mean SBP and nighttime mean SBP, and 24-hour mean SBP and morning mean SBP. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

a The variable eGFR was transformed using square root;

b the variable office SBP was logarithmically transformed;

c the variable Hs-CRP was logarithmically transformed.

Abbreviations: B, regression coefficient; OR, odds ratio; CI, confidence interval; BMI, body mass index; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast.

Table 3 Characteristics of men with and without nonalcoholic fatty liver disease

Variables	NAFLD patients (N=59)	Controls (N=22)	P-value
Age (years)	51±11	55±11	0.100
Waist circumference (cm)	106±12	92±10	<0.001
BMI (kg/m^2)	30±4.7	26±4	<0.001
Smoking (%)	32.7	27.8	0.695
eGFR (mL/min/1.73 m^2)	80±2	81±2	0.802
Hypertension (%)	76.3	86.4	0.321
Office SBP (mmHg)	153±19	149±13	0.290
Office DBP (mmHg)	93±13	91±8	0.526
24-hour mean SBP (mmHg)	135±13	131±10	0.168
24-hour mean DBP (mmHg)	84±11	83±7	0.716
Daytime mean SBP (mmHg)	141±14	137±9	0.300
Daytime mean DBP (mmHg)	89±11	88±7	0.816
Nighttime mean SBP (mmHg)	122±16	119±12	0.316
Nighttime mean DBP (mmHg)	73±11	71±8	1.000
Morning mean SBP (mmHg)	133±15	131±13	0.549
Morning mean DBP (mmHg)	84±11	83±7	0.813
White-coat hypertension (%)	11.9	12.5	0.293
AST (IU/L)	25±11	20±7	0.097
ALT (IU/L)	39±31	32±36	0.439
GGT (IU/L)	30±18	21±12	0.038
ALP (IU/L)	93±55	78±44	0.796
CHOL (mg/dL)	220±39	212±37	0.265
LDL (mg/dL)	148±46	136±30	0.205
HDL (mg/dL)	49±16	56±16	0.147
TRIGL (mg/dL)	138±75	109±50	0.127
Hs-CRP (mg/dL)	1.25±1.75	0.74±0.69	0.314
GLU (mg/L)	99±16	93±8	0.112

Notes: Data are presented as mean ± standard deviation. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

Abbreviations: NAFLD, nonalcoholic fatty liver disease; eGFR, estimated glomerular filtration rate; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast.

Table 4 Variables associated with nonalcoholic fatty liver disease in men

Variables	B	OR	95% CI	P-value
Bivariate analysis
Age (years)	−0.043	0.958	0.909–1.009	0.104
Waist circumference (cm)	0.141	1.152	1.066–1.244	,0.001
BMI (kg/m^2)	0.280	1.323	1.114–1.570	0.001
Smoking (yes)	0.235	1.265	0.391–4.097	0.695
eGFR (mL/min/1.73 m^2)a	0.011	1.011	0.692–1.477	0.957
Hypertension (yes)	−0.678	0.508	0.131–1.972	0.327
Office SBP (mmHg)b	0.679	1.972	1.972–7.668	0.634
Office DBP (mmHg)	0.014	1.014	0.971–1.060	0.521
24-hour mean SBP (mmHg)	0.031	1.031	0.987–1.077	0.170
24-hour mean DBP (mmHg)	0.010	1.010	0.959–1.063	0.712
Daytime mean SBP (mmHg)	0.021	1.022	0.981–1.063	0.298
Daytime mean DBP (mmHg)	0.006	1.006	0.959–1.055	0.814
Nighttime mean SBP (mmHg)	0.018	1.018	0.983–1.054	0.313
Nighttime mean DBP (mmHg)	0.010	1.010	1.038–1.059	0.967
Morning mean SBP (mmHg)	0.011	1.011	0.975–1.049	0.544
Morning mean DBP (mmHg)	0.006	1.006	0.956–1.059	0.810
White-coat hypertension (yes)	0.980	2.633	0.737–9.622	0.295
AST (IU/L)	0.060	1.062	0.987–1.142	0.093
ALT (IU/L)	0.008	1.008	0.988–1.029	0.443
GGT (IU/L)	0.062	1.064	1.004–1.127	0.035
ALP (IU/L)	−0.001	0.999	0.988–1.009	0.792
CHOL (mg/dL)	−0.007	0.993	0.980–1.006	0.262
LDL (mg/dL)	−0.010	0.990	0.975–1.005	0.205
HDL (mg/dL)	−0.025	0.975	0.943–1.009	0.149
TRIGL (mg/dL)	0.008	1.008	0.998–1.018	0.135
Hs-CRP (mg/L)c	0.371	1.449	0.503–4.172	0.492
GLU (mg/dL)	0.037	1.038	0.991–1.087	0.119
Multivariate logistic regressiona
BMI (kg/m^2)	0.213	1.237	1.047–1.461	0.012
GGT (IU/L)	0.055	1.056	0.991–1.127	0.093

Notes: Odds ratio and 95% CI adjusted by the variables with P<0.100 in bivariate analysis. BMI and waist circumference were not included in the same model because they are continuous variables with a correlation coefficient higher than 0.7. The same applies to 24-hour mean SBP and daytime mean SBP, 24-hour mean SBP and nighttime mean SBP, and 24-hour mean SBP and morning mean SBP. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

a The variable eGFR was transformed using square root;

b the variable office SBP was logarithmically transformed;

c the variable Hs-CRP was logarithmically transformed.

Abbreviations: B, regression coefficient; OR, odds ratio; CI, confidence interval; BMI, body mass index; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast.

Table 5 Characteristics of women with and without nonalcoholic fatty liver disease

Variables	NAFLD patients (N=104)	Controls (N=55)	P-value
Age (years)	56±10	55±11	0.592
Waist circumference (cm)	101±13	87±11	<0.001
BMI (kg/m^2)	30±6	25±4	<0.001
Smoking (%)	23.6	22.0	0.830
eGFR (mL/min/1.73 m^2)	84±2	84.5±2	0.732
Hypertension (%)	75.8	21.5	0.001
Office SBP (mmHg)	146±16	143±17	0.226
Office DBP (mmHg)	89±10	87±11	0.298
24-hour mean SBP (mmHg)	129±11	124±13	0.011
24-hour mean DBP (mmHg)	78±8	76±9	0.156
Daytime mean SBP (mmHg)	134±11	129±13	0.017
Daytime mean DBP (mmHg)	83±9	81±10	0.267
Nighttime mean SBP (mmHg)	119±12	111±20	0.004
Nighttime mean DBP (mmHg)	70±10	68±10	0.294
Morning mean SBP (mmHg)	130±13	123±17	0.012
Morning mean DBP (mmHg)	80±10	77±12	0.168
White-coat hypertension (%)	26	34.5	0.291
AST (IU/L)	20±6	19±5	0.132
ALT (IU/L)	23±11	19±10	0.018
GGT (IU/L)	22±14	14±6	<0.001
ALP (IU/L)	103±128	78±44	0.183
CHOL (mg/dL)	220±39	205±39	0.031
LDL (mg/dL)	138±39	131±37	0.274
HDL (mg/dL)	61±21	67±17	0.084
TRIGL (mg/dL)	126±57	89±50	<0.001
Hs-CRP (mg/L)	1.37±2.62	0.88±1.90	0.283
GLU (mg/dL)	94±10	90±9	0.019

Notes: Data are presented as mean ± standard deviation. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

Abbreviations: NAFLD, nonalcoholic fatty liver disease; BMI, body mass index; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast.

Table 6 Variables associated with nonalcoholic fatty liver disease in women

Variables	B	OR	95% CI	P-value
Bivariate analysis
Age (years)	0.009	1.009	0.976–1.044	0.589
Waist circumference (cm)	0.108	1.114	1.069–1.160	<0.001
BMI (kg/m^2)	0.217	1.242	1.122–1.375	0.001
Smoking (yes)	0.091	1.095	0.478–2.508	0.830
eGFR (mL/min/1.73 m^2)a	−0.147	0.864	0.651–1.145	0.309
Hypertension (yes)	1.194	3.300	1.650–6.600	0.001
Office SBP (mmHg)b	1.082	2.950	0.347–3.013	0.222
Office DBP (mmHg)	0.017	1.017	0.985–1.050	0.297
24-hour mean SBP (mmHg)	0.038	1.038	1.008–1.070	0.013
24-hour mean DBP (mmHg)	0.029	1.030	0.989–1.072	0.157
Daytime mean SBP (mmHg)	0.034	1.035	1.006–1.064	0.019
Daytime mean DBP (mmHg)	0.021	1.021	0.984–1.059	0.266
Nighttime mean SBP (mmHg)	0.034	1.034	1.009–1.061	0.008
Nighttime mean DBP (mmHg)	0.018	1.018	0.984–1.053	0.296
Morning mean SBP (mmHg)	0.029	1.030	1.006–1.054	0.014
Morning mean DBP (mmHg)	0.022	1.022	0.991–1.055	0.169
White-coat hypertension (yes)	−0.421	0.656	0.381–1.129	0.128
AST (IU/L)	0.052	1.053	0.984–1.128	0.137
ALT (IU/L)	0.051	1.052	1.007–1.100	0.024
GGT (IU/L)	0.098	1.103	1.042–1.166	0.001
ALP (IU/L)	0.005	1.005	0.997–1.014	0.180
CHOL (mg/dL)	0.010	1.010	1.001–1.020	0.035
LDL (mg/dL)	0.005	1.005	0.996–1.015	0.273
HDL (mg/dL)	−0.016	0.984	0.966–1.003	0.092
TRIGL (mg/dL)	0.018	1.018	1.008–1.028	<0.001
Hs-CRP (mg/dL)c	0.625	1.868	0.916–3.806	0.085
GLU (mg/L)	0.044	1.045	1.006–1.085	0.022
Multivariate logistic regressiona
BMI (kg/m^2)	0.245	1.277	1.080–1.511	0.004
Hypertension (yes)	1.892	6.631	1.626–27.035	0.008

Notes: Odds ratio and 95% CI adjusted by the variables (ALT, GGT, CHOL, HDL, TRIGL, and GLU) with P<0.100 in bivariate analysis. BMI and waist circumference were not included in the same model because they are continuous variables with a correlation coefficient higher than 0.7. The same applies to 24-hour mean SBP and daytime mean SBP, 24-hour mean SBP and nighttime mean SBP, and 24-hour mean SBP and morning mean SBP. Upper reference limits are 45 IU/L for AST, 45 IU/L for ALT, 55 IU/L for GGT, 150 IU/L for ALP, 200 mg/dL for CHOL, 140 mg/dL for LDL, 160 mg/dL for TRIGL, 5 mg/L for Hs-CRP, and 110 mg/dL for GLU in our laboratory. Lower reference limit is 35 mg/dL for HDL in our laboratory.

a The variable eGFR was transformed using square root;

b the variable office SBP was logarithmically transformed;

c the variable Hs-CRP was logarithmically transformed.

Abbreviations: B, regression coefficient; OR, odds ratio; CI, confidence interval; BMI, body mass index; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma glutamyl transpeptidase; ALP, alkaline phosphatase; CHOL, cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TRIGL, triglycerides; Hs-CRP, high-density c-reactive protein; GLU, glucose serum fast.