University of Mississippi Medical Center Jackson, MS
Saleha Aziz, MD1, Arsalan Hamid, MD1, Jan Petrasek, MD, PhD2 1University of Mississippi Medical Center, Jackson, MS; 2Texas Liver Institute, San Antonio, TX
Introduction: The association of liver stiffness with inflammation or obesity has been studied independently but not jointly. We aim to explore the synergistic relationship of these factors with liver stiffness.
Methods: We analyzed data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) and included adults ≥20 years with available liver transient elastography data, high sensitivity C-reactive protein (hsCRP), and other covariates of interest. Liver stiffness groups were mild, moderate, severe, and cirrhosis, ordinally. We used logistic regression models to assess the relationship between liver stiffness groups and high inflammation (hsCRP≥3 mg/dL) as well as obesity via body mass index (BMI; ≥30) and high waist-to-hip circumference ratio (WHR; ≥0.9 for males, ≥0.85 for females). These relationships were also evaluated on a continuous scale with linear regression models. All models were adjusted for age, sex, race, BMI, WHR, blood pressure, fasting glucose, and triglycerides. Statistical significance was set at p< 0.05.
Results: A total of 3,047 individuals had complete data. The mean age was 47±17 years, 50% were female, 64% were white, and 40% were obese. The mean hsCRP was 1.72 (0.76 to 3.96), liver stiffness was 5.55±3.51 kPa, and WHR was 0.93±0.08. Higher levels of inflammation (OR 1.62; 95% CI 1.19 to 2.2) and obesity by BMI (OR 4.13; 95% CI 2.53 to 6.73) were significantly associated with increased liver stiffness. Liver stiffness was also positively associated with log-hsCRP (β=0.34; 95% CI 0.10 to 0.57), BMI (β=0.13; 95% CI 0.07 to 0.19), and WHR (β=6.79; 95% CI 3.32 to 10.26). The combined effect of high inflammation and high WHR significantly increased the risk of higher liver stiffness. Additionally, log-hsCRP interacted with both BMI and WHR, leading to higher liver stiffness on a continuous scale.
Discussion: These findings highlight a significant interplay between inflammation, obesity, and liver stiffness. The combined presence of these conditions may accelerate liver damage, particularly in individuals with high inflammation and a high WHR. These results emphasize the importance of early detection and management of both inflammation and obesity to mitigate their impact on liver health.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Saleha Aziz indicated no relevant financial relationships.
Arsalan Hamid indicated no relevant financial relationships.
Jan Petrasek indicated no relevant financial relationships.
Saleha Aziz, MD1, Arsalan Hamid, MD1, Jan Petrasek, MD, PhD2. P4629 - Exploring the Association of Liver Stiffness With Inflammation and Waist-to-Hip Ratio: NHANES (2017 to 2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
