Hepatic steatosis index as an independent predictor of hypertension in patients with type 2 diabetes: a cross-sectional study

TL;DR

A study found that a liver fat marker called HSI is linked to high blood pressure in type 2 diabetes patients, suggesting it could help assess cardiovascular risk.

Contribution

This study demonstrates that the hepatic steatosis index is an independent predictor of hypertension in type 2 diabetes patients.

Findings

Patients with hypertension had significantly higher HSI levels compared to those without.

Hypertension prevalence increased with higher HSI quartiles.

HSI remained independently associated with hypertension after adjusting for confounders.

Abstract

Hypertension is a common comorbidity in type 2 diabetes mellitus (T2DM) and increases cardiovascular risk. Hepatic steatosis, a hallmark of metabolic dysfunction frequently observed in T2DM, may contribute to elevated blood pressure. The hepatic steatosis index (HSI) is a simple, non-invasive marker of liver fat, but its predictive value for hypertension in T2DM patients remains unclear.

This cross-sectional study retrospectively included 1,744 hospitalized T2DM patients at Linyi People’s Hospital from 2020 to 2023. Demographic, anthropometric, and laboratory data were collected, and HSI was calculated. Patients were classified as hypertensive (n = 604) or non-hypertensive (n = 1,140) and further stratified by HSI quartiles (Q1–Q4). Univariate and multivariate logistic regression analyses were performed to assess the association between HSI and hypertension.

Patients with hypertension had significantly higher HSI levels than those without (p < 0.05). Hypertension prevalence increased progressively across HSI quartiles, with the highest in Q4 (p < 0.01). In multivariate analysis, after adjustment for potential confounders, HSI remained independently associated with hypertension (OR = 1.054; 95% CI: 1.025–1.085; p < 0.001).

HSI is independently associated with hypertension in T2DM and may serve as a practical tool for risk stratification. These findings underscore the link between hepatic steatosis and cardiovascular risk, and further studies are warranted to confirm causality and clinical utility.

Figures