title: The association of nonalcoholic fatty liver disease with central and peripheral blood pressure in adolescence: findings from a cross-sectional study.
abstract: OBJECTIVE
  We aimed to determine the association of nonalcoholic fatty liver disease (NAFLD) with central and peripheral blood pressure (BP), in a general adolescent population and to examine whether associations are independent of adiposity.
  
  
  METHODS
  Using cross-sectional data from a subsample (N = 1904) of a UK birth cohort, we assessed markers of NAFLD including ultrasound scan (USS) determined fatty liver, shear velocity (marker of liver fibrosis), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) at a mean age of 17.8 years. These were related to BP [central and peripheral SBP and DBP and mean arterial pressure (MAP)].
  
  
  RESULTS
  Fatty liver was positively associated with central and peripheral SBP, DBP and MAP in models adjusting for age, sex, social class, puberty and alcohol intake. These positive associations were attenuated to the null when fat mass was included. For example, in confounder-adjusted models, not including fat mass, mean central SBP was 3.74 mmHg [95% confidence interval (CI) 1.12 to 6.36] higher in adolescents with USS fatty liver than in those without; with additional adjustment for fat mass, the association attenuated to the null value (-0.37 mmHg; 95% CI -3.09 to 2.36). Similar patterns were found for associations of ALT and GGT with central and peripheral BP. There was no consistent evidence of associations of shear velocity or AST with BP measurements. Fatty liver was not consistently associated with central pulse pressure (PP), peripheral PP and Aix@75.
  
  
  CONCLUSIONS
  NAFLD is not associated with higher central or peripheral BP in adolescents once confounding by adiposity is taken into account.
authors.affiliation: aSchool of Social and Community Medicine bMRC Integrative Epidemiology Unit at the University of Bristol, Bristol cInstitute of Cardiovascular Science, University College London, London dUniversity Hospitals Bristol National Health Service Foundation Trust, Bristol eInstitute of Cellular Medicine (C.D.), Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne fInstitute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: Sumaiya
authors.initials: S
authors.lastname: Patel
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: Diana L S
authors.initials: DL
authors.lastname: Ferreira
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: Mark
authors.initials: M
authors.lastname: Callaway
authors.forename: Chris
authors.initials: C
authors.lastname: Day
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Abigail
authors.initials: A
authors.lastname: Fraser
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009765:Obesity / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase