Association Between Hypertension And Non-Alcoholic Fatty Liver Disease: A Cross-Sectional And Meta-Analysis Study

Objective To investigate the association between hypertension and non-alcoholic fatty liver disease（NAFLD）in healthy subjects.Further,to conduct a meta-analysis combined with previous studies to explore whether hypertension is a risk factor for NAFLD.Methods 1.A total of 2049 adults aged 20 and above who participated in physical examination in a hospital in Yanbian from June to September 2017 were selected to measure physical indicators,blood routin examination indexes,liver function and kidney function indexes.The associations of abnormal blood pressure and hypertension with NAFLD were analyzed.Further,the interaction of hypertension and NAFLD risk factors were also analyzed;2.In six search platforms,previous domestic and foreign studies were included to combine with the results of this study for meta-analysis to obtain comprehensive results.Result First,the detection rate of NAFLD in the total study population was 39.2%（804/2049）,among which the detection rate of NAFLD in males was 53.5%（464/870）significantly higher than that in females 28.8%（340/1179）（P<0.001）.Second,（1）The abnormal SBP rate in male NAFLD group（26.9%）was higher than that in control group（18.7%）,and that in female NAFLD group（23.8%）was higher than that in control group（10.0%）.（2）The abnormal DBP rate in male NAFLD group（22.4%）was higher than that in control group（14.8%）,and that in female NAFLD group（15.0%）was higher than that in control group（5.8%）.（3）The detection rate of hypertension in male NAFLD group（31.9%）was higher than that in control group（24.4%）,and that in female NAFLD group（26.8%）was higher than that in control group（11.9%）.Third,（1）After adjustment,abnormal SBP was associated with NAFLD in males（OR=1.548,95%CI:1.046-2.291）,but this association disappeared in women（OR=1.453,95%CI:0.952-2.219）.（2）After adjustment,abnormal DBP was associated with NAFLD in males and females（OR=1.620,95%CI:1.066-2.463 and OR=1.896,95%CI:1.163-3.088,respectively）.（3）After adjustment,hypertension was associated with NAFLD in males（OR=1.469,95%CI:1.021-2.114）,but not in females（OR=1.418,95%CI:0.946-2.125）.Forth,After adjustment,there was an interaction effect between hypertension and overweight/obesity,abnormal FPG,abnormal TG,abnormal ALT and abnormal SUA in the prevalence of NAFLD in males(all P_{for interaction}<0.05);in females,there was an interaction effect between hypertension and overweight/obesity,abnormal FPG,abnormal TG,abnormal LDL-C and abnormal SUA in the prevalence of NAFLD(all P_{for interaction}<0.05).Fifth,as of August 31,2020,a total of 2828previous domestic and foreign studies were collected.After exclusion,11 cross-sectional design studies were finally included.The included studies were all published between 2008 and 2019,with a total population of 99,393,including 28,727 in the NAFLD group and 70,666 in the normal group.The average quality score of AHRQ cross-sectional study quality evaluation was6.82±0.60.Sixth,combined with the result of this study and using a fixed effect model,there is a association between hypertension and presence of NAFLD（OR=1.43,95%CI:1.36-1.51）,and hypertension is a risk factor for NAFLD（Z=12.96,P<0.001）.Conclusion1.After adjustment,both elevated blood pressure（abnormal SBP/abnormal DBP）and hypertension were closely associated with the presence of NAFLD in males,but only abnormal DBP was associated with the presence of NAFLD in females.2.After adjustment,there was an interaction effect between hypertension and overweight/obesity,abnormal FPG,abnormal TG,abnormal ALT and abnormal SUA in the prevalence of NAFLD in males;in females,there was an interaction effect between hypertension and overweight/obesity,abnormal FPG,abnormal TG,abnormal LDL-C and abnormal SUA in the prevalence of NAFLD.3.When combined with previous studies,hypertension remained a risk factor for NAFLD.