Abstract Body: Background: Cardiovascular disease (CVD) and liver dysfunction share metabolic pathways involving systemic inflammation and dysregulation. While evidence suggests liver dysfunction contributes to increased CVD risk, it is unclear whether individuals with higher predicted CVD risk also have poorer liver function.
Hypothesis: We hypothesized that individuals with higher predicted CVD risk, assessed by the PREVENT equation, would also have poorer liver function, measured by the non-invasive Fibrosis-4 (FIB-4) index.
Methods: We conducted a cross-sectional analysis of pooled NHANES 2011–Pre-pandemic 2020 data. Eligible participants (n=12,733) with complete data for both PREVENT and FIB-4 scores were included. PREVENT scores estimated 10-year CVD risk; FIB-4 was calculated using age, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and Platelet counts. Associations were examined using weighted linear regression, with PREVENT and FIB-4 modeled bidirectionally.
Results: Higher PREVENT risk was significantly associated with elevated FIB-4 scores (β = 0.07; 95% CI: 0.06, 0.08; p < 0.001), and higher FIB-4 was associated with increased PREVENT risk (β = 2.17; 95% CI: 1.16, 3.19; p < 0.001). Risk increased progressively across categories of both scores (all p<0.001).
Conclusions: Higher predicted CVD risk is linked with poorer liver function, and higher FIB-4 scores independently predict increased CVD risk. Integrating liver function into CVD risk prediction models may improve long-term risk stratification and patient outcomes.