Association of estimated liver fibrosis with carotid but not femoral atherosclerotic burden: the ILERVAS cohort
Por:
León-Mengíbar, J, Malagón, MM, Bermúdez-López, M, Valdivielso, JM, Pamplona, R, Torres, G, Mauricio, D, Castro, E, Fernández, E, Caixàs, A, Hernández, M, Lopez-Cano, C, Gordon, A, Guzman-Ruiz, R, Cusi, K, Lecube, A
Publicada:
6 ene 2026
Resumen:
Introduction: Advanced liver fibrosis, a key complication of metabolic dysfunction-associated steatotic liver disease, has been increasingly linked to extrahepatic conditions, including type 2 diabetes, obesity, and cardiovascular disease. However, the specific association of liver fibrosis in the development and progression of subclinical atheromatous disease across vascular territories remains poorly understood. This study evaluates the utility of two non-invasive indices to predict liver fibrosis and their associations with subclinical atheromatous plaque burden and distribution. Methods: Atheromatous plaque burden (plaque presence, number, and total area) was assessed in the carotid and femoral territories via ultrasonography in 3,981 middle-aged participants without known cardiovascular disease, diabetes, or liver disease from the ILERVAS cohort (ClinicalTrials.gov Identifier: NCT03228459). The fibrosis-4 (FIB-4) and the NAFLD Fibrosis Score (NFS) were evaluated. FIB-4 risk categories were defined as low (<1.30), intermediate (1.30-2.67), and high (>2.67). Results: Participants in the intermediate and high-risk FIB-4 categories exhibited a higher prevalence of carotid atheromatous disease (56.8% vs. 49.5%, p<0.001), a greater number of plaques (p<0.001), and a larger total plaque area (p=0.007). Multivariable analyses confirmed FIB-4 as an independent predictor of carotid plaque burden (OR: 1.14, 95% CI 1.05-1.24, p=0.003), even adjusting for traditional cardiovascular risk factors. Moving from low to high FIB-4 cut-offs was associated with 12.6% higher odds of carotid atherosclerosis. NFS was also independently associated with carotid atheromatosis (OR 1.10, 95% CI 1.05-1.15, p<0.001). No significant associations were found in the femoral territory for either index. Conclusions: Estimated liver fibrosis, particularly FIB-4, is a valuable marker for identifying carotid subclinical atherosclerosis in populations without known liver disease. These findings highlight the importance of vascular territory-specific evaluations and support their utility in integrated liver and cardiovascular risk assessment strategies.
Filiaciones:
León-Mengíbar, J:
Univ Hosp Arnau de Vilanova Lleida, Endocrinol & Nutr Dept, Lleida, Spain
Univ Lleida, Lleida Biomed Res Inst IRBLleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
Malagón, MM:
Univ Cordoba UCO, Maimonides Inst Biomed Res Cordoba IMIB, Biomed Res Network Ctr Pathophysiol Obes & Nutr CI, Dept Cell Biol Physiol & Immunol,Inst Salud Carlos, Cordoba, Spain
Bermúdez-López, M:
ISCIII, Renal Res Network RICORS2040, Lleida Biomed Res Inst IRBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Univ Lleida, Dept Expt Med, Lleida, Spain
Valdivielso, JM:
ISCIII, Renal Res Network RICORS2040, Lleida Biomed Res Inst IRBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Pamplona, R:
Univ Lleida, Lleida Biomed Res Inst IRBLleida, Dept Expt Med, Lleida, Spain
Torres, G:
Univ Hosp Arnau de Vilanova & Santa Maria, Lleida Biomed Res Inst IRBLleida, Biomed Res Network Ctr Resp Dis CIBERes, Inst Hlth Carlos 3,Translat Res Resp Med, Lleida, Spain
Mauricio, D:
Autonomous Univ Barcelona, Hosp Santa Creu i St Pau, Biomed Res Network Ctr Diabet & Metab Dis CIBERdem, Dept Endocrinol & Nutr,Inst Salud Carlos 3, Barcelona, Spain
Castro, E:
ISCIII, Renal Res Network RICORS2040, Lleida Biomed Res Inst IRBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Fernández, E:
ISCIII, Renal Res Network RICORS2040, Lleida Biomed Res Inst IRBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Caixàs, A:
Parc Tauli Hosp Univ, Inst Res & Innovat Parc Tauli Ctr Res Catalonia IP, Endocrinol & Nutr Dept, Sabadell, Spain
Univ Autonoma Barcelona, Med Dept, Sabadell, Spain
Hernández, M:
Univ Hosp Arnau de Vilanova Lleida, Endocrinol & Nutr Dept, Lleida, Spain
Univ Lleida, Lleida Biomed Res Inst IRBLleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
Lopez-Cano, C:
Univ Hosp Arnau de Vilanova Lleida, Endocrinol & Nutr Dept, Lleida, Spain
Univ Lleida, Lleida Biomed Res Inst IRBLleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
Gordon, A:
Univ Cordoba UCO, Maimonides Inst Biomed Res Cordoba IMIB, Biomed Res Network Ctr Pathophysiol Obes & Nutr CI, Dept Cell Biol Physiol & Immunol,Inst Salud Carlos, Cordoba, Spain
Guzman-Ruiz, R:
Univ Cordoba UCO, Maimonides Inst Biomed Res Cordoba IMIB, Biomed Res Network Ctr Pathophysiol Obes & Nutr CI, Dept Cell Biol Physiol & Immunol,Inst Salud Carlos, Cordoba, Spain
Cusi, K:
Univ Florida, Div Endocrinol Diabet & Metab, Gainesville, FL 32611 USA
Lecube, A:
Univ Hosp Arnau de Vilanova Lleida, Endocrinol & Nutr Dept, Lleida, Spain
Univ Lleida, Lleida Biomed Res Inst IRBLleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
Univ Hosp Vall dHebron, Endocrinol & Nutr Dept, Barcelona, Spain
Autonomous Univ Barcelona, Inst Recerca Vall dHebron VHIR, Diabet & Metab Res Grp, CIBER Diabet & Metab Dis CIBERdem, Barcelona, Spain
Green Submitted, gold
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