ArticlePloS one2016
The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 39 citations in OpenAlex.
- Cardiovascular Implications in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review.Korean circulation journal · 2026Review
- The Relationship Between the Serum Aspartate Aminotransferase/Alanine Aminotransferase Ratio and the Occurrence and Progression of Abdominal Aortic Aneurysms: A Cross-Sectional Study.Brazilian journal of cardiovascular surgery · 2026Article
- Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus.Diabetology & metabolic syndrome · 2025Article
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- Hematology profile, digestive enzymes, thyroid hormones, productivity, and nitrogen balance of growing male rabbits supplemented with exogenous dietary lysozyme.Animal biotechnology · 2023Article
- How Cardiac Fibrosis Assessed via T1 Mapping Is Associated with Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease.Journal of clinical medicine · 2023Article
- Aspartate aminotransferase/alanine aminotransferase ratio was associated with type 2 diabetic peripheral neuropathy in a Chinese population: A cross-sectional study.Frontiers in endocrinology · 2023Article
- DNA methylation GrimAge version 2.Aging · 2022Article
- Prognostic value of dynamic cardiac biomarkers in patients with acquired refractory thrombocytopenic purpura: A retrospective study in Chinese population.Journal of clinical laboratory analysis · 2022Article
- Elevated AST/ALT ratio is associated with all-cause mortality in patients with stable coronary artery disease: a secondary analysis based on a retrospective cohort study.Scientific reports · 2022Article
- Hypertension is prevalent in non-alcoholic fatty liver disease and increases all-cause and cardiovascular mortality.Frontiers in cardiovascular medicine · 2022Article
- Residential greenness attenuated associations of long-term exposure to air pollution with biomarkers of advanced fibrosis.Environmental science and pollution research international · 2022Article
- The association between hypertension and nonalcoholic fatty liver disease (NAFLD): literature evidence and systems biology analysis.Bioengineered · 2021Article
- Association of the Non-Alcoholic Fatty Liver Disease Fibrosis Score with subclinical myocardial remodeling in patients with type 2 diabetes: A cross-sectional study in China.Journal of diabetes investigation · 2021Article
- AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction.BMC research notes · 2020Article
- Non-alcoholic fatty liver disease, liver fibrosis score and cognitive function in middle-aged adults: The Framingham Study.Liver international : official journal of the International Association for the Study of the Liver · 2019Article
- Article
- Prevalent Cardiovascular Disease Events and T1 Mapping Defined Hepatic Fibrosis.Circulation. Cardiovascular imaging · 2018Article
- A novel biomarker for prediction of atrial fibrillation susceptibility in patients with celiac disease.PloS one · 2018Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsNon-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular related death, particularly in those with hepatic fibrosis. We determined the prevalence of predicted fibrosis based on non-invasive fibrosis markers and the association of hepatic fibrosis with cardiovascular risk factors.
methodsCross-sectional study of 575 Framingham Heart Study participants with NAFLD based on computed tomography. We determined the prevalence of predicted fibrosis based on the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST to platelet ratio index (APRI), the Fibrosis-4 score (FIB4), and the NAFLD Fibrosis Score (NFS). Using multivariable logistic regression models, we examined the association between low, indeterminate, or high risk for fibrosis according to the NFS and various cardiometabolic risk factors.
resultsThe predicted risk of fibrosis was 12%, 4%, 5%, and 32% for the NFS, FIB4, APRI, and AST/ALT ratio, respectively. In multivariable models, participants with a high risk for advanced fibrosis by the NFS had a wider pulse pressure (adjusted mean difference = 6.87 mm Hg; p = 0.0002) and an increased odds of hypertension (OR 2.92; p = 0.007) compared to those with low risk of fibrosis. There were no statistically significant differences between other cardiovascular risk factors for those with a high versus low risk of fibrosis.
conclusionsThe AST/ALT ratio, APRI, and NFS give widely disparate predictions of liver fibrosis. Participants with a high risk for fibrosis based on NFS had wider pulse pressure and increased odds of hypertension. Whether modifying these risk factors impacts cardiovascular endpoints in NAFLD patients remains unknown.
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