Association of FIB-4 with orthostatic hypotension in Parkinson's disease

Orthostatic hypotension (OH) is a common complication in Parkinson's disease (PD) patients, significantly impacting their quality of life. Recent evidence suggests a potential link between liver fibrosis, indicated by the Fibrosis-4 (FIB-4) index, and autonomic dysfunction. However, its relationship with OH in PD remains unexplored.

A cross-sectional analysis was conducted using data from 1268 PD patients. The FIB-4 index was calculated based on age, AST, ALT, and platelet count. The association between FIB-4 and OH was assessed using multivariate logistic regression, with further curve fitting and subgroup analyses to test robustness.

The FIB-4 index was significantly associated with OH. For each 0.2-unit increase in FIB-4, the odds ratio (OR) for OH was 1.11 (95% CI: 1.05-1.17, p < 0.001). Tertile analysis showed ORs of 2.05 (95% CI: 1.27-3.31, p = 0.003) for T2 and 2.61 (95% CI: 1.64-4.17, p < 0.001) for T3, compared to T1. Curve fitting indicated a linear relationship, with no evidence of non-linearity. Sensitivity and subgroup analyses confirmed robustness.

Higher FIB-4 index values are independently associated with an increased risk of OH in PD patients, suggesting that liver fibrosis may contribute to OH development. Further longitudinal studies are needed to explore the underlying mechanisms.