Alcohol Intake and Cardiometabolic Risk Factors Are Independently Associated With a Higher AST/Platelet Ratio Index in Obese Males

Abstract

It remains unclear whether alcohol intake and cardiometabolic factors are simultaneously associated with liver fibrosis progression in Japanese obese patients. This study investigated factors influencing liver fibrosis progression using the Aspartate Aminotransferase/Platelet Ratio Index (APRI), which does not include age. We conducted a cross-sectional study of 26 737 obese (BMI ≥ 25 kg/m²) adults undergoing health checkups. Steatotic liver disease (SLD) was diagnosed via ultrasonography. Clinical characteristics were analysed according to BMI category and APRI to identify risk factors for advanced liver fibrosis (APRI > 1.0). The prevalence of type 2 diabetes, hypertension, and SLD increased with increasing BMI. On multivariable analysis in male, significant risk factors for advanced liver fibrosis included increased BMI (BMI 30–34.9 kg/m²: OR 2.64, 95% CI 1.89–3.69, p < 0.001; BMI 35–39.9 kg/m²: OR 2.67, 95% CI 1.89–3.69, p = 0.002; BMI ≥ 40 kg/m²: OR 3.51, 95% CI 1.24–9.96, p = 0.018), SLD (OR 2.13, 95% CI 1.49–3.05, p < 0.001), moderate alcohol intake (OR 1.36, 95% CI 1.03–1.79, p = 0.031), heavy alcohol intake (OR 4.31, 95% CI 2.90–6.40, p < 0.001), high blood pressure (OR 1.30, 95% CI 1.01–1.67, p = 0.044), and high fasting blood glucose (OR 1.61, 95% CI 1.12–2.28, p = 0.008). In female, only age > 65 years (OR 3.02, 95% CI1.93–4.73, p < 0.001), BMI, and high uric acid (OR 2.06, 95% CI 1.15–3.68, p = 0.015) were extracted. In an obese male, alcohol intake and cardiometabolic factors were associated with liver fibrosis progression based on APRI, independent of elevated BMI and SLD.