Nonalcoholic fatty liver disease is associated with... : Hepatology (original) (raw)

Steatohepatitis/Metabolic Liver Disease

Nonalcoholic fatty liver disease is associated with coronary artery calcification

Kim, Donghee1,*; Choi, Su-Yeon1; Park, Eun Ha2; Lee, Whal3; Kang, Jin Hwa4; Kim, Won5; Kim, Yoon Jun6; Yoon, Jung-Hwan6; Jeong, Sook Hyang2; Lee, Dong Ho2; Lee, Hyo-suk6; Larson, Joseph7; Therneau, Terry M.7; Kim, Ray W.8

1_Departments of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea_

2_Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea_

3_Department of Radiology, Seoul National University Hospital, Seoul, Korea_

4_Radiology, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea_

5_Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea_

6_Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea_

7_Divisions of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota_

8_Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota_

*Address reprint requests to: Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System, Gangnam Center, 39FL, Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul, 135-984, South Korea

Email:[email protected]

Received 25 August 2011; Accepted 26 December 2011

Potential conflict of interest: Nothing to report.

Supported by grant 04-2009-055 from the Seoul National University Hospital Research Fund.

The funding organizations had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is related to risk factors of coronary artery disease, such as dyslipidemia, diabetes, and metabolic syndrome, which are closely linked with visceral adiposity. The aim of this study was to investigate whether NAFLD was associated with coronary artery calcification (CAC), which is used as a surrogate marker for coronary atherosclerosis independent of computed tomography (CT)-measured visceral adiposity. Out of 5,648 subjects who visited one of our health screening centers between 2003 and 2008, we enrolled 4,023 subjects (mean age, 56.9 ± 9.4 years; 60.7% males) without known liver disease or a history of ischemic heart disease. CAC score was evaluated using the Agatston method. On univariate analysis, the presence of CAC (score >0) was significantly associated with age, sex, body mass index, aspartate aminotransferase, alanine aminotransferase, high-density lipoprotein cholesterol, triglycerides, and increased risk of diabetes, hypertension, smoking, and NAFLD. Increasing CAC scores (0, <10, 10-100, ≥100) were associated with higher prevalence of NAFLD (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.61-2.10; P <0.001). Multivariable ordinal regression analysis was adjusted for traditional risk factors, and CT-measured visceral adipose tissue area in a subgroup of subjects showed that the increased CAC scores were significantly associated with the presence of NAFLD (OR, 1.28, 95% CI, 1.04-1.59; P = 0.023) independent of visceral adiposity. Conclusion: Patients with NAFLD are at increased risk for coronary atherosclerosis independent of classical coronary risk factors, including visceral adiposity. These data suggest that NAFLD might be an independent risk factor for coronary artery disease. (HEPATOLOGY 2012)