title: A Prospective Study of Fatty Liver Index and Incident Hypertension: The KoGES-ARIRANG Study.
abstract: BACKGROUND
  Although non-alcoholic fatty liver disease is the hepatic manifestation of metabolic syndrome, its influence on hypertension development is poorly understood. We investigated whether fatty liver disease, as assessed by the fatty liver index, could predict the development of hypertension independently of systemic insulin resistance, inflammatory status and adipokine levels.
  
  
  METHODS
  Prospective cohort study of 1,521 adults (484 men and 1037 women) aged 40 to 70 years without baseline hypertension examined. An equation was used to calculate fatty liver index and classify patients as follows: fatty liver index <30, no non-alcoholic fatty liver disease; fatty liver index ≥ 60, non-alcoholic fatty liver disease; and 30 ≤ fatty liver index <60, intermediate fatty liver index.
  
  
  RESULTS
  During an average of 2.6 years of follow-up, 153 subjects (10.06%) developed hypertension. Fatty liver index was positively associated with baseline blood pressure, homeostasis model assessment of insulin resistance, urinary albumin/creatinine excretion, and high sensitivity C-reactive protein. After adjustment for confounding factors, including markers of insulin resistance, systemic inflammation and adiponectin levels, the odds ratio [95% confidence interval] for the incident hypertension increased in a graded manner with fatty liver index (<30 vs. 30-59 vs. ≥ 60 = 1 vs. 1.83 [1.16~2.88] vs. 2.09 [1.08~4.055], respectively).
  
  
  CONCLUSIONS
  Non-alcoholic fatty liver disease assessed by fatty liver index was an independent risk factor for hypertension. Our findings suggest that fatty liver index, a simple surrogate indicator of fatty liver disease, might be useful for identifying subjects at high risk for incident hypertension in clinical practice.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Wonju College of Medicine, Wonju, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Huh
authors.affiliation: Department of Preventive Medicine, Institute of Genomic Cohort, Wonju College of Medicine, Wonju, Korea.
authors.forename: Song Vogue
authors.initials: SV
authors.lastname: Ahn
authors.affiliation: Department of Preventive Medicine, Institute of Genomic Cohort, Wonju College of Medicine, Wonju, Korea.
authors.forename: Sang Baek
authors.initials: SB
authors.lastname: Koh
authors.affiliation: Institute of Life Style Medicine, Wonju College of Medicine, Wonju, Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
authors.forename: Jang Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ki-Chul
authors.initials: KC
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Jeong Bae
authors.initials: JB
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology / Q000473:pathology*