Metabolic dysfunction-associated fatty liver disease and risk of hypertension in young adults: A cross-sectional study mediated by inflammatory markers

This study aimed to investigate the prevalence of hypertension among young adults with MAFLD, assess the association between the presence and severity of MAFLD and hypertension, and explore potential mediating mechanisms linking MAFLD and hypertension in this population. A total of 5,327 individuals aged 18−45 years from the National Health and Nutrition Examination Survey (2017−2023) were included. Multivariable logistic regression analysis was performed to evaluate the independent associations of MAFLD and its severity with hypertension and isolated diastolic hypertension. Mediation analysis assessed the mediating effects of inflammatory markers, including white blood cell (WBC) count, neutrophil count, and systemic immune-inflammation index (SII). The prevalence of MAFLD in the study population was 44.05%. Hypertension prevalence in the MAFLD group was significantly higher than in the non-MAFLD group (37.68% vs. 15.19%, P P MAFLD, particularly in the presence of advanced liver fibrosis, is strongly and independently associated with hypertension in young adults. Systemic inflammation acts as a key mediator in this relationship, highlighting its potential as a therapeutic target for precision antihypertensive strategies in this population.

本研究旨在探讨代谢相关脂肪性肝病（MAFLD）青年人群的高血压患病率，评估MAFLD的存在与严重程度和高血压之间的关联，并探索该人群中连接MAFLD与高血压的潜在介导机制。本研究共纳入来自2017-2023年美国国家健康与营养检查调查（National Health and Nutrition Examination Survey）的5327名年龄18~45岁的受试者。采用多变量logistic回归分析，评估MAFLD及其严重程度与高血压及孤立性舒张期高血压的独立关联。介导分析则针对包括白细胞（white blood cell, WBC）计数、中性粒细胞计数及全身免疫炎症指数（systemic immune-inflammation index, SII）在内的炎症标志物，对其介导效应进行评估。本研究人群中MAFLD的患病率为44.05%。MAFLD组的高血压患病率显著高于非MAFLD组（37.68% vs. 15.19%, P < 0.001）。校正混杂因素后，MAFLD及其严重程度均与高血压风险升高呈独立相关（均P < 0.05），且该关联在合并晚期肝纤维化的人群中更为显著。研究结果显示，MAFLD（尤其是合并晚期肝纤维化者）与青年人群的高血压存在强而独立的关联；全身炎症在这一关联中发挥关键介导作用，提示其有望成为该人群精准降压治疗的潜在干预靶点。