Fatty Liver Disease, Women, and Aldosterone: Finding a Link in the Jackson Heart Study

Abstract

Context:Fatty liver disease is one of the most common forms of chronic liver disease. The renin-angiotensin-aldosterone system has been implicated in the pathogenesis of fatty liver.Objective:Determine the relationship between fatty liver and aldosterone in a large cohort study.Design:Community-based, observational cohort study of African Americans.Setting:The original Jackson Heart Study cohort enrolled African American participants from the Jackson, Mississippi, metropolitan area in Hinds, Madison, and Rankin Counties.Participants:Our study population consisted of 2507 Jackson Heart Study participants (1625 women and 882 men) who had liver attenuation measured per computed tomography scans, had aldosterone measurements, and were not taking angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or mineralocorticoid receptor antagonists.Intervention:There was no intervention.Main outcome measure:Liver attenuation on computed tomography scans.Results:Univariate regression analysis demonstrated a statistically significant correlation between aldosterone levels and liver attenuation. Each doubling of aldosterone was associated with 1.08 Hounsfield unit decrease (95% confidence interval, 1.47 to −0.69, P < 0.001). A multivariable model adjusted for body mass index, age, alcohol intake, and homeostatic model assessment of insulin resistance determined that the association was statistically significant only for women.Conclusion:Our data demonstrate a positive association between aldosterone levels and fatty liver in African American women.

The Effects of Continual Consumption of Origanum vulgare on Liver Transcriptomics

“…In the liver, the aldosterone level is increased in liver fibrosis [ 22 ] and can increase the levels of liver fat consistently enough to be used as a predictor of liver fat levels [ 23 ]. Aldosterone is also involved in the pathogenesis of the fatty liver disease [ 24 ] and in the pathogenesis of obesity and overweight [ 25 , 26 ]. Fat metabolism and oxidation were also inhibited in our dataset ( Figure 4 ) and reduction of the fat oxidation category is likely partially controlled by the inhibited and downregulated HNF4A—hepatocyte nuclear factor 4 alpha transcription factor ( Figure 4 ).…”

Unanticipated increases in hepatic steatosis among human immunodeficiency virus patients receiving mineralocorticoid receptor antagonist eplerenone for non‐alcoholic fatty liver disease

“…Mounting evidence from animal models suggests that the use of MR antagonists, such as eplerenone, study showed an association between increased aldosterone and fatty liver in black women, demonstrating that perturbations in the renin-angiotensin-aldosterone system likely affect hepatic steatosis. 15 Regardless of mechanism, this pilot study provides preliminary data suggesting that the pathophysiological benefits of MR antagonism seen in animal models may not translate directly into humans.…”

Adiposity, aldosterone and plasma renin activity among African Americans: The Jackson Heart Study

“…The relationship between liver attenuation and aldosterone has previously been investigated in the JHS ( Kumar et al, 2017 ). Investigators identified a negative association between aldosterone and liver attenuation which was significant only among women.…”