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However, there are no prospective longitudinal assessments of the association between PAI\u20101 and NAFLD. We aimed to describe the association between PAI\u20101 levels in early adulthood with NAFLD in midlife.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among the 5115 participants in the coronary artery risk development in young adults (CARDIA) study, participants were randomly selected from a subset that was free of obesity, diabetes and hypertension at the 1992\u20101993 exam and attended the 2005\u20102006 exam (n\u00a0=\u00a0996). A subset of participants (n\u00a0=\u00a0896) also had CT liver fat measured (2010\u20102011). Participants with secondary causes of steatosis were excluded (n\u00a0=\u00a087). NAFLD was defined as liver attenuation \u226451 Hounsfield units. Logistic regression models assessed the association between PAI\u20101 and NAFLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 809 participants, 53% were female, 37% black with a mean age of 32\u00a0years. Median PAI\u20101 level at 1st assessment (1992\u20101993) was 23.4\u00a0ng\/mL among participants with NAFLD vs 11.9\u00a0ng\/mL among those without NAFLD (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Median PAI\u20101 level at 2nd assessment (2005\u20102006) was 55.6\u00a0ng\/mL among participants with NAFLD vs 19.5\u00a0ng\/mL among those without NAFLD (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Higher PAI\u20101 levels were independently associated with NAFLD (1st assessment adjusted OR [AOR] 2.16 per 1 standard deviation higher log(PAI\u20101) level (95% confidence interval [CI] 1.63\u20102.85); 2nd assessment AOR 2.71 (95% CI 2.03\u20103.61)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plasma PAI\u20101 levels in young adulthood were independently associated with NAFLD in midlife. Further studies may indicate whether PAI\u20101 plays a role in NAFLD pathophysiology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14417","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T04:41:27Z","timestamp":1582519287000},"page":"1111-1120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between plasminogen activator inhibitor\u20101 in young adulthood and nonalcoholic fatty liver disease in midlife: CARDIA"],"prefix":"10.1111","volume":"40","author":[{"given":"Patrick T.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Medicine Northwestern University Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-2573","authenticated-orcid":false,"given":"Lisa B.","family":"VanWagner","sequence":"additional","affiliation":[{"name":"Division of GI &amp; Hepatology Northwestern 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