BACKGROUND Although arterial stiffness has been reported to be associated with nonalcoholic fatty liver disease (NAFLD), previous studies have relied only on noninvasive assessments for the diagnosis of NAFLD. This study attempted to investigate the association of arterial stiffness with the histological severity of NAFLD.

METHODS We analyzed data from a biopsy-proven prospective NAFLD cohort. Augmentation index corrected for a heart rate of 75 bpm (AI@75) was obtained using applanation tonometry of the radial artery.

RESULTS A total of 154 patients (mean age 55.2 years; females 55.8%) with biopsy-proven NAFLD were analyzed. Patients with higher AI@75 (≥ 76%) showed more severe grades of lobular and portal inflammation and hepatocellular ballooning, and more advanced stages of fibrosis compared to those with lower AI@75 (< 76%) (p < 0.05 for each). The presence of nonalcoholic steatohepatitis (NASH) (adjusted odds ratio [aOR] 2.48; 95% confidence interval [CI] 1.31-6.16; p = 0.008), lobular inflammation (aOR 2.03; 95% CI 1.09-3.78; p = 0.025) hepatocellular ballooning (aOR 2.82; 95% CI 1.23-6.43; p = 0.014), and significant fibrosis (≥ F2) (aOR 3.42; 95% CI 1.50-7.79; p = 0.003) were independently associated with higher AI@75 (≥ 76%) even after adjustment for confounders.

CONCLUSION Arterial stiffness as indicated by higher AI@75 was associated with more severe NAFLD histology. This adds to the evidence for the association between increased arterial stiffness and NAFLD.