HEPATIC FIBROSIS INDICES CORRELATE WITH MICROVASCULAR REMODELLING: PRELIMINARY RESULTS FROM A MASLD PATIENTS’ COHORT

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) conveys an increased cardiovascular risk. Fibrosis-4 Index (FIB-4 Index) and AST to Platelet Ratio Index (APRI) are two scores for the non-invasive assessment of hepatic fibrosis in MASLD patients while Fatty Liver Index (FLI) is a surrogate score of steatotic liver. Hypertension is characterized by microvascular remodelling, which has a known prognostic significance in terms of cardiovascular events. Whether hepatic fibrosis and microvascular remodelling indices correlate in MASLD and hypertension is unknown. Our aim was to assess the correlation between indices of hepatic fibrosis and microvascular remodelling in hypertensive patients with or without MASLD. Design and method: Twentythree patients were recruited: 20 met MASLD’s diagnostic criteria (13 hypertensives and 7 normotensives), and 3 hypertensive patients without any hepatic disease. Patients with diabetes, cancer, autoimmune diseases and other hepatic diseases were excluded in order to avoid a possible confounding effect on microvascular remodelling parameters. Retinal arteriolar morphology was assessed by Adaptive Optics. Blood chemistries were performed to compute APRI, FIB-4, FLI. Results: Clinical Characteristics and retinal arteriole parameters are reported in the Table. FIB-4 directly correlates with the retinal external and internal arteriolar diameter (rho = 0.434; p = 0.049 and 0.581; p = 0.006, respectively), the wall cross-sectional area (WCSA, rho = 0.665; p = 0.001), and age (rho = 0.661; p = 0.001). A direct correlation was observed between WCSA and age (rho = 0.460; p = 0.027). APRI and FLI didn’t show any significant correlation with remodelling parameters.Conclusions: Among FLI, APRI and FIB-4 only the latter showed a significant correlation with retinal arteriolar morphology. Moreover, FIB-4 is directly correlated with outward hypertrophic remodelling, a vascular morphological impairment resulting from inflammatory and pro-oxidant damages.