Dyslipidemia and Hypertension as Independent Risk Factors for Non-Alcoholic Steatohepatitis: A Matched Case-Control Study from Qatar

Background: Non-alcoholic steatohepatitis (NASH), the progressive form of non-alcoholic fatty liver disease, is increasingly prevalent in the Middle East. Although NASH is widely regarded as a hepatic manifestation of metabolic syndrome, population-specific evidence on individual metabolic risk factors remains limited in Gulf Cooperation Council countries. Objective: To quantify the independent associations of dyslipidemia and hypertension with NASH using statistical methods appropriate for matched case–control data. Methods: We conducted a retrospective 1:1 age- and sex-matched case–control study using electronic health records from the Primary Health Care Corporation (PHCC), Qatar. The study included 894 NASH cases and 894 matched controls. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), accounting for the matched design. Univariable and multivariable models were fitted for dyslipidemia and hypertension. Results: Dyslipidemia was present in 56.0% of cases and 47.0% of controls, while hypertension was present in 52.0% and 45.5%, respectively. Among the 894 matched pairs, 333 (37.2%) were discordant for dyslipidemia and 290 (32.4%) for hypertension. In multivariable conditional logistic regression, both dyslipidemia (adjusted OR = 1.56; 95% CI: 1.25–1.96; p < 0.001) and hypertension (adjusted OR = 1.39; 95% CI: 1.09–1.77; p = 0.007) were independently associated with NASH. Conclusions: Dyslipidemia and hypertension are independent risk factors for NASH in this Qatari population. These findings support targeted metabolic risk assessment and management strategies in primary care to mitigate NASH development and progression.