Portal Hypertension in Non-alcoholic Fatty Liver Disease: Association With Cardiovascular Risk and Identification of Non-invasive Biomarkers (THESIS)

Inclusion Criteria: * Age between 18 and 65 years. * Clinical suspicion of NAFLD. * Severe (controlled attenuation parameter (CAP) ≥330 dB/m) or mild steatosis (CAP: 298-317 dB / m), and FibroScan® grade 2 fibrosis (M probe: 7-9 kpa; XL probe: 5-7.5 kpa) in patients with grade 1 or 2 obesity and insulin resistance (HOMA index\> 2.6) or diabetes mellitus. * Fibroscan® grade 3 or 4 fibrosis (M probe:\> 9 kpa; XL probe:\> 7.5 kpa). * Decompensated NAFLD cirrhosis (i.e. development of ascites, variceal hemorrhage, and/or hepatic encephalopathy) up to Child B (9 points). * Signature of informed consent. Exclusion Criteria: * Concomitant liver disease and patients with acute on chronic liver failure. * Excessive alcohol consumption (≥ 30 grams per day in men and ≥ 20 grams per day in women). * Comorbidities (HIV infection, connective diseases, prothrombotic disorders) and/or drugs (didanosine, azathioprine, oxaliplatin) associated with the presence of idiopathic non-cirrhotic portal hypertension. * Clinical history of cardiovascular disease (ischemic cardiomyopathy, atrial fibrillation, valvular defects, severe arterial hypertension, previous hospitalizations secondary to heart failure, cerebrovascular disease). * Severe renal impairment, defined by creatinine clearance \<15 ml/min/1.73m2. * Any previous or current thrombosis in any venous territory. * Uncontrolled psychiatric illness * Contraindication to liver biopsy or any of the complementary tests included in the project. * Hepatocellular carcinoma that does not meet Milan criteria. * Pregnancy or breastfeeding * Significant comorbidities that entail a functional limitation and/or a life expectancy of less than 12 months.