Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES

Abstract Background There is a known association between liver disease and retinopathy. However, the relationship between non-invasive fibrosis scores and retinal image changes remains unknown. The research sought to explore the link between Fibrosis-4 score (FIB‐4) and Fibrosis‐8 score (FIB-8) and...

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Main Authors: Chuan-Xi Wang, Jing-Jing Hou, Si-Yu Lin, Jiang-Hui Wang, Jing-Jing Ding, Chang Liu, Zheng-Xuan Jiang, Ning Bao
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-00805-6
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author Chuan-Xi Wang
Jing-Jing Hou
Si-Yu Lin
Jiang-Hui Wang
Jing-Jing Ding
Chang Liu
Zheng-Xuan Jiang
Ning Bao
author_facet Chuan-Xi Wang
Jing-Jing Hou
Si-Yu Lin
Jiang-Hui Wang
Jing-Jing Ding
Chang Liu
Zheng-Xuan Jiang
Ning Bao
author_sort Chuan-Xi Wang
collection DOAJ
description Abstract Background There is a known association between liver disease and retinopathy. However, the relationship between non-invasive fibrosis scores and retinal image changes remains unknown. The research sought to explore the link between Fibrosis-4 score (FIB‐4) and Fibrosis‐8 score (FIB-8) and retinal image changes. Methods This cross-sectional study included participants with complete information on FIB-4/FIB-8, retinal images and covariates from two cycles of the National Health and Nutrition Examination Surveys (NHANES) 2005–2008. We converted FIB-4 to the categorical variable according to its correlation with liver fibrosis staging (< 1.3, 1.3–2.67, ≥ 2.67; <1.45, 1.45–3.25, > 3.25). Weighted multifactorial logistic regression was used to assess the association between FIB-4、 FIB-8 and retinal image changes, and Restricted Cubic Spline (RCS) and smoothed curve fitting were used to examine the dose-response relationship between FIB-4, FIB-8 and retinal image changes. Results The cross-sectional study included a total of 3399 participants (1715 men; 1684 women) with a mean age of 62.27 (9.49) years. Following comprehensive adjustments, a positive correlation was identified between FIB-4, FIB-8, and retinal image changes. When FIB-4 was converted to a categorical variable, there was a 62% increased risk of retinal image changes in higher FIB-4 group compared to the control group [OR:1.62,95% CI (1.01,2.59)]. Additionally, the relationship between FIB-4 and retinal image changes was found to be non-linear, while the association between FIB-8 and retinal image changes presented a linear pattern. Subgroup analyses and interactions showed that there was a significant interaction between economic situation and educational level and FIB-4, whereas there was no interaction between the variables of interest and FIB-8. Conclusion Among individuals aged fifty years and older, FIB-4 and FIB-8 are linked to a higher risk of retinal image changes, particularly among those with advanced liver fibrosis. Our findings suggest that patients with severe fibrosis should also be monitored for retinal health.
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spelling doaj-art-4831c3de27684a8e8fe4286af8b933fd2025-08-20T02:01:30ZengBMCJournal of Health, Population and Nutrition2072-13152025-02-014411910.1186/s41043-025-00805-6Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANESChuan-Xi Wang0Jing-Jing Hou1Si-Yu Lin2Jiang-Hui Wang3Jing-Jing Ding4Chang Liu5Zheng-Xuan Jiang6Ning Bao7Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityAbstract Background There is a known association between liver disease and retinopathy. However, the relationship between non-invasive fibrosis scores and retinal image changes remains unknown. The research sought to explore the link between Fibrosis-4 score (FIB‐4) and Fibrosis‐8 score (FIB-8) and retinal image changes. Methods This cross-sectional study included participants with complete information on FIB-4/FIB-8, retinal images and covariates from two cycles of the National Health and Nutrition Examination Surveys (NHANES) 2005–2008. We converted FIB-4 to the categorical variable according to its correlation with liver fibrosis staging (< 1.3, 1.3–2.67, ≥ 2.67; <1.45, 1.45–3.25, > 3.25). Weighted multifactorial logistic regression was used to assess the association between FIB-4、 FIB-8 and retinal image changes, and Restricted Cubic Spline (RCS) and smoothed curve fitting were used to examine the dose-response relationship between FIB-4, FIB-8 and retinal image changes. Results The cross-sectional study included a total of 3399 participants (1715 men; 1684 women) with a mean age of 62.27 (9.49) years. Following comprehensive adjustments, a positive correlation was identified between FIB-4, FIB-8, and retinal image changes. When FIB-4 was converted to a categorical variable, there was a 62% increased risk of retinal image changes in higher FIB-4 group compared to the control group [OR:1.62,95% CI (1.01,2.59)]. Additionally, the relationship between FIB-4 and retinal image changes was found to be non-linear, while the association between FIB-8 and retinal image changes presented a linear pattern. Subgroup analyses and interactions showed that there was a significant interaction between economic situation and educational level and FIB-4, whereas there was no interaction between the variables of interest and FIB-8. Conclusion Among individuals aged fifty years and older, FIB-4 and FIB-8 are linked to a higher risk of retinal image changes, particularly among those with advanced liver fibrosis. Our findings suggest that patients with severe fibrosis should also be monitored for retinal health.https://doi.org/10.1186/s41043-025-00805-6Liver fibrosisFibrosis 4 scoreFibrosis 8 scoreRetinopathyCross-sectional study
spellingShingle Chuan-Xi Wang
Jing-Jing Hou
Si-Yu Lin
Jiang-Hui Wang
Jing-Jing Ding
Chang Liu
Zheng-Xuan Jiang
Ning Bao
Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
Journal of Health, Population and Nutrition
Liver fibrosis
Fibrosis 4 score
Fibrosis 8 score
Retinopathy
Cross-sectional study
title Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
title_full Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
title_fullStr Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
title_full_unstemmed Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
title_short Association between liver fibrosis’s noninvasive scores and retinal imaging changes: insights from NHANES
title_sort association between liver fibrosis s noninvasive scores and retinal imaging changes insights from nhanes
topic Liver fibrosis
Fibrosis 4 score
Fibrosis 8 score
Retinopathy
Cross-sectional study
url https://doi.org/10.1186/s41043-025-00805-6
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