Metabolic Dysfunction-Associated Fatty Liver Disease in Newly Diagnosed, Treatment-Naive Hypertensive Patients and Its Association with Cardiorenal Risk Markers

Introduction Patients with arterial hypertension frequently present with comorbidities that are associated with increased cardiorenal risk, such as metabolic dysfunction-associated fatty liver disease (MAFLD). Aims Our study aimed to assess the prevalence and the association of MAFLD with cardiorenal risk markers in newly diagnosed, treatment-naïve hypertensive patients. Methods We recruited 281 individuals with new-onset hypertension who were not prescribed any medication. Medical history, clinical examination findings, and laboratory test results were recorded. Liver steatosis was assessed through fatty liver index (FLI) calculation. Patients with FLI ≥ 60 together with one main metabolic abnormality (type 2 diabetes mellitus or overweight/obesity) or at least two metabolic risk abnormalities (increased waist circumference, blood pressure, plasma triglycerides, presence of prediabetes or insulin resistance, decreased plasma high-density lipoprotein) fulfilled the diagnostic criteria for MAFLD. Results The prevalence of MAFLD in our study population was 28.7%. Individuals with MAFLD were more frequently male and had increased body mass index. Systolic, diastolic, and pulse pressure values were significantly higher in this group of patients. Moreover, lipid, renal, glucose, and inflammatory markers were considerably deranged in patients with MAFLD. After multivariate regression analysis, uric acid, ferritin, and apoE emerged as independent predictors of MAFLD. Area under receiver operating characteristics curve revealed that uric acid had the greatest diagnostic accuracy, with the ideal cutoff being ≥ 5.2 mg/dl (sensitivity: 77.6%, specificity: 76.3%). Conclusion MAFLD represents a common comorbidity in hypertensive patients and is associated with markers of cardiorenal risk. Uric acid may be indicative of MAFLD in particular.