The Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and Peripheral Arterial Disease in the Chinese Population

Xiao-Hui Song,1,&ast; Bo Liu,2,3,&ast; Fang Lei,2,4 Ye-Mao Liu,2,5,6 Xingyuan Zhang,2,4 Ze Chen,7 Peng Zhang,2,4 Xiao-Jing Zhang,2,4 Zhi-Gang She,1,2 Jingjing Cai,2,8 Jin-Hua Wang,9 Hongliang Li1– 3,6 1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 2Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China; 3Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 4School of Basic Medical Science, Wuhan University, Wuhan, People’s Republic of China; 5Department of Cardiology, Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China; 6Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China; 7Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 8Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 9Department of Neurology, Huanggang Central Hospital of Yangtze University, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongliang Li, Department of Cardiology, Renmin Hospital of Wuhan University, Luojia Mount Wuchang, Wuhan, 430072, People’s Republic of China, Tel/Fax +86-27-68759302, Email lihl@whu.edu.cn Jin-Hua Wang, Department of Neurology, Huanggang Central Hospital of Yangtze University, Hubei, 438000, People’s Republic of China, Email wangjinhua1985@qq.comPurpose: Emerging evidence suggested that metabolic dysfunction-associated fatty liver disease (MAFLD) was significantly associated with atherosclerotic diseases. Atherosclerosis in the peripheral arteries is the most common cause of peripheral arterial disease (PAD), which has not been substantially controlled in the past. We aimed to investigate the association between MAFLD and PAD in the Chinese population.Patients and Methods: This observational study covered 102,115 participants who underwent health checkups with detailed examinations for PAD and MAFLD. PAD was measured by ankle-brachial index, and MAFLD was diagnosed by abdominal ultrasound. The generalized linear mixed models and random-effects Cox proportional hazards models were used to analyze the relationship between MAFLD and PAD.Results: The baseline characteristics showed that patients with MAFLD had higher prevalence of PAD compared with those without MAFLD (2.7% vs 2.2%). Compared to non-MAFLD, the individuals with MAFLD were associated with a higher risk of the presence of PAD (adjusted odds ratio: 1.30, 95% confidence interval (CI): 1.19– 1.42, P < 0.001). In the prospective cohort study, 6833 participants underwent a follow-up of 2.76 (standard deviation: 1.36) years, and MAFLD at baseline was a higher risk of associated with incident PAD (adjusted hazards ratio: 1.67, 95% CI: 1.17– 2.38, P = 0.005). Moreover, with the accumulation of metabolic abnormalities, the risk of the PAD was increased in the individuals with MAFLD. Furthermore, MAFLD attributed risk of PAD was more evident in participants without metabolic comorbidities.Conclusion: MAFLD was associated with a significantly higher risk for the prevalence and incidence of PAD in the Chinese population. The finding suggested that individuals with MAFLD are not only have a higher risk of coronary heart diseases but also have an increased risk of atherosclerosis in peripheral arteries.Keywords: chronic liver disease, metabolic disorder, arteriosclerosis, cross-sectional study, prospective cohort study