Investigators at First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China conducted a study to ascertain the independent effect of mean arterial pressure (MAP) on incident nonalcoholic fatty liver disease (NAFLD) among nonobese individuals with normal low-density lipoprotein cholesterol (LDL-C) levels.

Overall, 16,153 nonobese participants without NAFLD at baseline were recruited in the study. Participants were segregated into four groups based on quartiles of MAP from Q1 to Q4. A gender-based subgroup analysis was also done. Participants were diagnosed to have NAFLD using ultrasonography.

Over a mean follow-up of 2.80 years, the cumulative incidence of NAFLD was 14.37 with incidence rate estimated as 513.17 per 10,000 person-years. The cumulative incidence of NAFLD for the entire population or gender groups was found to show a steady increase with the quartiles of MAP. In the Q4 of MAP, the cumulative incidence of NAFLD for the entire population, male, and female was 6.22 (5.75-6.70), 6.70 (6.21-7.19), and 5.69 (5.24-6.14), respectively. When adjustment was done for potential confounders, the hazard ratio for NAFLD was estimated as 1.328 (1.072-1.647), 1.625 (1.276-2.069), and 1.697 (1.231-2.340) for Q2, Q3, and Q4, respectively, in comparison with Q1. Subgroup analysis demonstrated the respective hazard ratio for NAFLD in Q2, Q3, and Q4 as 1.760 (1.276-2.429), 2.080 (1.433-3.019), and 2.377 (1.452-3.890), compared with females in Q1. However, MAP was shown not to be associated with incident NAFLD in males. MAP had a larger area under the receiver-operating characteristic curves compared to SBP or DBP, with optimal cutoff point of 88 mmHg in males and 89 mmHg in females.

To conclude, MAP appears to independently predict incident NAFLD among nonobese females with normal LDL levels.

Source: Xu S, Chen L, Hong D, et al. Mean Arterial Pressure Is Related to Incident Nonalcoholic Fatty Liver Disease among the Nonobese Female with Normal Low-Density Lipoprotein Cholesterol Levels: A Large Cohort Study in China. Gastroenterol Res Pract. 2020 Jan 17;2020:3580840.