Renal Denervation Improves Hepatic Steatosis in Hypertensive Patients With Metabolic Syndrome

BACKGROUND: Sympathetic overactivity is associated with hepatic steatosis. Renal denervation (RDN) is an approved treatment for uncontrolled hypertension through sympathetic modulation; however, its hepatic effects are unknown. This study aimed to assess the effects of RDN on noninvasive tests for hepatic steatosis. METHODS: This single-center study included patients with uncontrolled hypertension and cardiometabolic comorbidities undergoing RDN (n=32) or a sham procedure (n=10). Noninvasive tests for hepatic steatosis, including the hepatic steatosis index (HSI) and fatty liver index (FLI), were calculated at baseline and follow-up visits. An external cohort from the UK Biobank was used to validate the correlation between proton density fat fraction magnetic resonance imaging scans of the liver and these surrogates. RESULTS: Compared with the control group, RDN significantly reduced HSI at 3 months (0.4±0.5 versus −1.3±0.3; P =0.009), 6 months (0.0±0.9 versus −2.6±0.5; P =0.027), and 12 months (0.0±0.6 versus −2.1±0.5; P =0.013), as well as FLI at 3 months (2.6±2.2 versus −3.8±1.2; P =0.021), 6 months (4.1±2.4 versus −5.7±1.2; P =0.002), and 12 months (2.0±2.7 versus −6.2±1.3; P =0.018). No significant differences were found in HSI (−1.9±0.7 versus −2.2±0.7; P =0.77) and FLI (−7.1±1.8 versus −5.3±1.7; P =0.49) between subjects in the intervention group whose office blood pressure decreased above or below the median of 19.5 mm Hg after 12 months. In the UK Biobank, correlation analysis showed a significant relationship between proton density fat fraction magnetic resonance imaging and HSI ( r =0.40; P