REN and Hypertension: Hypertension promotes endothelial dysfunction, arterial stiffness, and activation of the renin–angiotensin–aldosterone system, which could interact with hepatic lipid accumulation to exacerbate cardiovascular and renal outcomes.[42,43] Collectively, these findings suggest that the interplay between metabolic stress, hormonal environment, and vascular health modulates the strength of the FLI–CKM association across subgroups.