Association Between Fatty Liver Index and Brachial-Ankle Pulse Wave Velocity in the General Population　- A Cross-Sectional Study.

Background: Although metabolic dysfunction-associated fatty liver disease is typically diagnosed using ultrasonography, the fatty liver index (FLI) offers a simple alternative. Brachial-ankle pulse wave velocity (baPWV) is an established marker of arterial stiffness and a predictor of cardiovascular events. This study investigated the association between FLI and baPWV in a general Japanese population. Methods and Results: This cross-sectional study included participants aged ≥18 years, excluding those with atrial fibrillation, lower extremity artery disease, severe aortic stenosis, or missing data. The primary outcome was an elevated baPWV (≥1,800 cm/s). Multivariable logistic regression analysis was performed to assess the association between FLI and elevated baPWV, considering FLI both as a categorical variable (low risk: FLI <30; moderate risk: FLI ≥30 and <60; high risk: FLI ≥60) and as a continuous variable (per 10-unit increase). The analysis included 10,122 individuals (mean age 54.3 years; 55% male). In multivariable-adjusted models, the odds of elevated baPWV were significantly higher in the moderate-risk (odds ratio [OR] 1.47; 95% confidence interval [CI] 1.20-1.79) and high-risk (OR 1.78; 95% CI 1.33-2.38) groups, using the low-risk group as the reference category. Each 10-unit increase in FLI was associated with significantly higher odds of the outcome (OR 1.16; 95% CI 1.10-1.22). Conclusions: FLI showed a significant association with arterial stiffness in the general Japanese population.