Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine
Original article

Fibrosis-4 index: A new marker to predict non-dipper blood pressure pattern in patients with newly diagnosed hypertension

Índice de fibrosis-4: un nuevo marcador para predecir el patrón de presión arterial no dipper en pacientes con hipertensión recién diagnosticada

Uğur Küçük, Kadir Arslan

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Introduction: Epicardial fat tissue (EFT) is a significant risk factor for cardiovascular diseases. This study aimed to investigate whether there is a relationship between the fibrosis-4 index (FIB-4 index) and EFT in newly-diagnosed hypertensive patients and explore the usability of the FIB-4 index in predicting non-dipper blood pressure (BP) pattern.
Materials and methods: Our case–control study consisted of 210 patients in 3 groups according to BP values, namely normotensive, dipper, and non-dipper groups. Transthoracic echocardiography and 24-h ambulatory BP monitoring were performed in all patients.
Results: The median FIB-4 index was higher in the non-dipper group [1.56 (1.10-2)] than in the dipper [1 (0.71-1.32)] and normotensive groups [0.96 (0.69-1.32)] (p < 0.001, for both). A positive correlation was observed between EFT and the FIB-4 index (r=0.389, p<0.001). In multivariate logistic regression analysis, EFT (odds ratio (OR): 0.506, 95% confidence interval (CI): 1.288-2.135; p<0.001) and FIB-4 index (OR: 1.099, 95% CI: 1.621–5.556; p<0.001) were found to be independent predictors of non-dipper BP. In the receiver operating characteristic curve analysis, the FIB-4 index had 68% sensitivity and 72% specificity at a value >1.25 (area under the curve: 0.751, 95%CI: 0.679-0.823, p<0.001).
Conclusions: In newly-diagnosed hypertensive people, the FIB-4 index is related to non-dipper BP patterns. FIB-4 index appears to be a helpful tool in assessing risk associated with cardiovascular disease.


Hypertension; Non-dipper; Fibrosis-4 index; Epicardial adipose tissue


Introducción: El tejido graso epicárdico (TGE) es un importante factor de riesgo de enfermedades cardiovasculares. Este estudio tuvo como objetivo investigar si existe una relación entre el índice de fibrosis-4 (índice FIB-4) y TGE en pacientes hipertensos recién diagnosticados y explorar la utilidad del índice FIB-4 para predecir la presión arterial (PA) no dipper. patrón.
Materiales y métodos: Nuestro estudio de casos y controles consistió en 210 pacientes en 3 grupos según los valores de PA, a saber, grupos normotensos, dipper y no dipper. A todos los pacientes se les realizó ecocardiografía transtorácica y monitorización ambulatoria de la PA de 24 h.
Resultados: La mediana del índice FIB-4 fue mayor en el grupo no dipper [1,56 (1,10-2)] que en los grupos dipper [1 (0,71-1,32)] y normotensos [0,96 (0,69-1,32)] (p<0.001, para ambos). Se observó una correlación positiva entre TGE y el índice FIB-4 (r = 0,389, p < 0,001). En análisis de regresión logística multivariante, EFT (odds ratio (OR): 0,506, intervalo de confianza (IC) 95%: 1,288-2,135; p<0,001) e índice FIB-4 (OR: 1,099, IC95%: 1,621-5,556; p<0,001) resultaron ser predictores independientes de PA no dipper. En el análisis de la curva característica operativa del receptor, el índice FIB-4 tuvo una sensibilidad del 68 % y una especificidad del 72 % a un valor >1,25 (área bajo la curva: 0,751, IC95%: 0,679-0,823, p<0,001).
Conclusiones: En hipertensos de nuevo diagnóstico, el índice FIB-4 se relaciona con patrones de PA no dipper. El índice FIB-4 parece ser una herramienta útil para evaluar el riesgo asociado con la enfermedad cardiovascular.

Palabras clave

Hipertensión; No-dipper; Índice de fibrosis-4; Tejido adiposo epicárdico


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