{
  "abstract": "Objective High blood pressure (BP) is one of the optional components of metabolic dysfunction-associated fatty liver disease (MAFLD). However, whether subclinical elevations in BP are related to MAFLD even in the absence of hypertension remains unclear. We investigated the association between BP and MAFLD among adults without hypertension.Design and setting A nationwide, multicentre and cross-sectional study of the National Health and Nutrition Examination Survey (NHANES).Participants 2022 US adults without hypertension were recruited in the 2017–2018 cycle of the NHANES.Exposure Systolic BP (SBP) and diastolic BP (DBP).Outcome measures MAFLD was defined by the novel consensus of diagnostic criteria in 2020.Results MAFLD is common among US adults even at the ‘normal’ BP ranges, with a prevalence of 38.8%. We observed a positive, linear relationship between SBP and MAFLD down to 90 mm Hg, and between DBP and MAFLD down to 50 mm Hg. The MAFLD risk was elevated significantly with increasing SBP level (per 10 mm Hg increase: adjusted OR, 1.59 (95% CI, 1.21 to 2.09)) in the range of 90–129 mm Hg. The relationship between DBP and MAFLD was not evident (per 10 mm Hg increase: adjusted OR, 1.42 (95% CI, 0.96 to 2.21)) in the range of 50–79 mm Hg. Similar findings were identified in the sensitivity analyses.Conclusions In a population without hypertension, SBP is significantly associated with MAFLD, indicating potential early intervention to prevent MAFLD.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China",
        "Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China"
      ],
      "name": "Shujing Wu"
    },
    {
      "affiliations": [
        "Department of Endocrine and Metabolic Diseases, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China"
      ],
      "name": "Ning Chen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China",
        "Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China"
      ],
      "name": "Mengzhang Wu"
    },
    {
      "affiliations": [
        "Shanghai Jiuxin Health Technology Co., Ltd, Shanghai, China"
      ],
      "name": "Yongquan Wang"
    },
    {
      "affiliations": [
        "School of Public Health, Xiamen University, Xiamen, Fujian, China"
      ],
      "name": "Zhaoming Huang"
    },
    {
      "affiliations": [
        "School of Public Health, Xiamen University, Xiamen, Fujian, China"
      ],
      "name": "Jie Zhang"
    },
    {
      "affiliations": [
        "School of Public Health, Xiamen University, Xiamen, Fujian, China"
      ],
      "name": "Jianan Li"
    },
    {
      "affiliations": [
        "Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China",
        "Department of Cardiac Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China"
      ],
      "name": "Demin Xu"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China",
        "Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China"
      ],
      "name": "Lihua Guan"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China",
        "Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China"
      ],
      "name": "Junbo Ge"
    }
  ],
  "title": "Association between blood pressure and metabolic dysfunction-associated fatty liver disease among adults without hypertension: a cross-sectional analysis of the National Health and Nutrition Examination Survey 2017–2018",
  "uid": "745280eb-0ee9-5ebd-89f6-32996b7d180e"
}