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

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.