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National Journal of Medical Research, 2023
Background: Non-alcoholic fatty liver disease (NAFLD) is a growing concern due to its potential to lead to liver transplants and its association with cardiovascular disease (CVD). However, the relationship between NAFLD and CVD remains debated, and non-invasive diagnostic methods for NAFLD are recommended. This study aimed to estimate the prevalence of NAFLD among patients with CAD and explore the association between CAD severity and the probability of developing NAFLD. Methodology: A cross-sectional study was conducted among CAD patients. Patients with a history of infectious liver disease, pregnant or lactating individuals, and those with excessive alcohol consumption were excluded. Coronary angiography was performed to assess CAD severity using the Gensini score. Ultrasonography and non-invasive assessments, such as the Fibrosis-4 (FIB-4) index, were used to diagnose and stage NAFLD. Result: The study included 156 CAD patients, with 79 (50.6%) being male. Out of total, 31 (19.8%) had severe, 79(50.6%) had moderate, and 46 (29.48%) had mild NAFLD. Male patients showed a significantly higher prevalence of severe NAFLD compared to females. There was no significant difference in the mean age of CAD patients across NAFLD severities. Severe NAFLD was associated with higher mean Gensini scores and FIB-4 values compared to mild to moderate NAFLD patients. A positive correlation was found between Gensini score and FIB4, suggesting that Gensini score could be an alternative to FIB4 in diagnosing NAFLD severity among CAD patients. Conclusion: The study revealed a high prevalence of NAFLD among CAD patients, with severe NAFLD being associated with higher CAD severity.
Sultan Qaboos University Medical Journal, 2010
ObjectivesThe objective of this study was to identify the presence of non-alcoholic fatty liver disease (NAFLD) in patients with coronary artery disease (CAD).Methods149 patients were selected, who had been referred to the Institute of Cardiology, Banglore, India, between January 2007 and June 2009 and diagnosed with CAD. Four patients did not participate in the study. Venous blood samples were taken from these cases, and agematched healthy controls who came for a master health check-up (N = 100). All were subjected to routine liver function tests including serum transaminases, enzyme immunoassays for plasminogen activator inhibitor I (PAI-I), C reactive protein (CRP), and tumour necrosis factor-alpha (TNF-α). Using ultrasonography and serum alanine aminotransferase (ALT) levels, the presence of NAFLD in CAD patients was reported.ResultsCAD patients with NAFLD had significantly higher liver enzymes and marginally higher A1C levels compared to control subjects. Levels of TNF-α and PAI-I were higher in CAD patients with NAFLD compared to both female and male controls (P <0.1 and P <0.05). Levels of CRP (P <0.01 in both groups) and uric acid were increased in both group of patients (P <0.05 and P <0.01 in male and female patients, respectively). Levels of adiponectin were significantly reduced in the patients compared to the controls (P <0.05 and P <0.001) in male and female patients respectively.ConclusionThe increased serum levels of PAI-I and TNF-α reflected the proinflammatory status in these CAD patients which may be due to the presence of NAFLD. This could contribute additively to the development of cardiovascular events (CVD).
Clinical outcomes of non-alcoholic fatty liver disease: Polish-case control study
Advances in Clinical and Experimental Medicine, 2019
Background. Non-alcoholic fatty liver disease (NAFLD) is becoming the most common cause of chronic liver disease worldwide, affecting up to 30% of population. Non-alcoholic fatty liver disease can lead to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Age, obesity, insulin resistance, type 2 diabetes, and dyslipidemia are important risk factors for developing hepatic steatosis. Concomitant diseases, especially cardiovascular, are discussed as important causes of death in NAFLD patients. Objectives. The objective of this study was to conduct a retrospective comparison of the frequency of concomitant diseases in NAFLD patients and controls, especially metabolic syndrome and cardiovascular disease (CVD). Material and methods. A total of 1,058 (558 NAFLD patients and 500 controls). Diagnosis of NAFLD was established with ultrasound examination in the absence of other causes of fatty liver. The control group included patients with no history of liver disease, normal liver image in ultrasound examination and normal liver laboratory tests. Results. Overweight and/or obesity were diagnosed in 80.8% of patients in the study group and 40.8% in the controls (p < 0.001). Metabolic syndrome was present in 48.7% patients in the study group compared with 14.4% controls, (p < 0.001). In the study group, we found higher prevalence of hypertension (56. 1% vs 37%; p < 0.001), type 2 diabetes mellitus (24.4% vs 8.6%; p < 0.001), decreased concentration of serum HDL (35. 1% vs 19.5%; p < 0.001), elevated serum triglycerides (36.5% vs 15.4%; p < 0.001). Cardiovascular disease was found in 13.6% of individuals in the study group and in 15% controls (NS, p = 0.32). The most frequent concomitant gastrointestinal disease present in the study group was gastroesophageal reflux disease (GERD) (31.9% vs 22.8%; p < 0.001) followed by colonic diverticulosis (23.7% vs 15.8%; p < 0.005). Conclusions. Metabolic syndrome with its components is more common in NAFLD patients compared to matched controls. Additionally, NAFLD patients are more often affected by GERD and colonic diverticulosis but not by CVD.
JGH open, 2022
Background and AimNon‐alcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent worldwide, and cardiovascular diseases are the most common cause of death in NAFLD patients. The present study aimed to evaluate the possible relationship between the presence and severity of NAFLD and coronary artery disease (CAD).MethodsA cross‐sectional study was conducted on 296 patients (122 men and 174 women, with mean age 54.10 ± 9.33 years) referred to the catheterization laboratory of Imam Reza Hospital affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, for elective coronary angiography to investigate the presence and severity of CAD. Additionally, all patients underwent abdominal ultrasonography (USG) to detect NAFLD and its severity.ResultsAmong the 296 patients, 187 (63.2%) had CAD and 160 (50.1%) had NAFLD. NAFLD patients had significantly higher prevalence of obesity (odds ratio [OR] = 1.047, 95% confidence interval [CI] = 1.002–1.094), hypertension (OR = 1.909, 95% CI = 1.027–3.55), hyperlipidemia (OR = 3.474, 95% CI = 1.862–6.482), and CAD (OR = 2.009, 95% CI = 1.100–3.669). The percentage of patients with normal vessels was higher in the non‐NAFLD group, followed by the group with mild and severe NAFLD (P < 0.001). However, single‐ and multi‐vessel disease incidences among the non‐NAFLD, mild, and severe NAFLD groups were 36.1, 43.1, and 63.7%, respectively. Interestingly, the percentage of patients with two‐vessel stenosis was significantly higher in severe NAFLD patients than mild and non‐NAFLD patients (P < 0.001).ConclusionThe prevalence and severity of NAFLD were independently associated with CAD. Mild NAFLD was primarily observed among patients with normal and non‐obstructive coronary artery patients, while severe NAFLD was more frequent in extensive CAD patients with multi‐vessel disease.
Correlation of non alcoholic fatty liver disease in patients of coronary artery disease
International Journal of Research in Medical Sciences, 2016
Ischemic heart disease is the generic designation for a group of pathophysiologically related syndromes ABSTRACT Background: In NAFLD, increase in factor VIII and a reduction of protein C leads to the progression from steatosis to cirrhosi. The aim was to study the correlation of NAFLD with other associated risk factors of CAD. Methods: A total number of 100 patients of coronary artery disease were assessed for presence of NAFLD, dyslipidemia, metabolic syndrome & diabetes by various laboratory tests. Results: 46% of the CAD patients were found to have NAFLD. 69.6% patients of NAFLD were in the age group of 40-60 years. 21.7% were above 60 years. 91.1% of NAFLD patients were males. Half of the NAFLD patients were diabetic. 21.7% of NAFLD patients were found to have a total cholesterol level >200. Triglyceride level was also high among these patients (58.7%). All the NAFLD patients had LDL <100. 52.2% of them had metabolic syndrome. Conclusions: The study showed a direct correlation between NAFLD & CAD. Metabolic syndrome, diabetes, increased total cholesterol & triglyceride level were also associated with increased risk for CAD. However LDL level was not found to be associated with NAFLD risk.
The prevalence of NAFLD in CAD and it’s correlation with their severity
Panacea Journal of Medical Sciences
To study the prevalence of Non-Alcoholic Fatty Liver Disease in Coronary Artery Disease patient and the correlation of Coronary Artery Disease severity in patients of Non-Alcoholic Fatty Liver Disease Study included 124 patients of Coronary Artery Disease who underwent detailed clinical and anthropometric examination and routine blood investigations. Ultrasonography of abdomen was done and Non-Alcoholic Fatty Liver Disease grading was done. Coronary angiography was done and angiographic severity was calculated by Gensini score. Non-Alcoholic Fatty Liver Disease was found in 71% of patient. There is a significant difference of Gensini score between patients with and without Non-Alcoholic Fatty Liver Disease. All the stage of Non-Alcoholic Fatty Liver Disease had a significant difference of Gensini score among them with but there was no difference of Gensini score between stage 1 and 2. The presence of Non-Alcoholic Fatty Liver Disease Is associated with a higher Gensini score, howeve...
Epidemiology of Non-Alcoholic Fatty Liver Disease: A Primary Health Care Based Study
Background and aim: The prevalence of Non-alcoholic fatty liver disease is markedly increasing in the past decade, in association to a linked increase in other comorbidities; mainly metabolic syndrome. As insufficient data, exist in the literature regarding the prevalence and predisposing factors among patients in Saudi Arabia. This study aimed to estimate the frequency and associated risk factors of NAFLD detected in abdominal ultrasound requested by primary care physicians in Prince Sultan military medical city, Riyadh, KSA. To properly identify high-risk groups for early detection, management, decreasing the associated morbidity and mortality. Methods: A cross sectional study with a total of 143 patients enrolled from primary health centers of PSMMC. All patients were adults who are not known to have hepatic disease, and their abdomen ultrasound requested by Primary health cares from March to September 2020. An estimation of prevalence and correlation with common risk factors was done. Whereas Electronic health records were used for data collection including demographical data, Clinical measurements, laboratory workup, medication history and indication of ultrasound request. Result: The estimated prevalence of NAFLD detection in ultrasound was 78 patients (54.5%). With a female (n=52, 67%) to male (n=26, 33%) predominance. The highest detection was among patients who are 18-35 years of age (n=49, 34.4%). As per clinical risk factors, the majority were found to be overweight (n= 34, 23.8%, p-value= 0.003), with normal systolic (n=105, 73.4%, p-value=0.339) and diastolic (n=87, 60.8%, p-value=0.819) blood pressure. The highest associated detection of NAFLD was among patients with thyroid disorders (n=16, 84%), then hypertensive (n=22, 73%), then diabetics (n= 21, 70%), then dyslipidemias (n=15, 68%), and cardiovascular (n=4, 50%). The strongest associated biochemical risk factors were suboptimal HBa1c (n=20, 74%, p-value=0.066), and elevated LDL cholesterol (n= 8, 73%, p-value=0.272). As per medication history, majority were on either hypertensive (n=23, 79%), diabetic (n=21, 70%) or dyslipidemia (n=15, 68%) therapy. Finally, the most common ultrasonographic indication was abdominal pain (n=31, 48%). Conclusions: The exact prevalence of NAFLD is underestimated. With a clear bidirectional association with metabolic syndrome parameters. Therefore, we recommend physicians to control the previously mentioned comorbidities to prevent further development of fatty liver. We recommend against the routine ultra-sonographic screening, with a tailored approach for screening only high-risk metabolic syndrome patients. Finally, emphasizing on the need for further larger scaled-census; to establish an exact population prevalence and establishing a validated clinical criterion for which patients' to be screened for fatty liver disease.
The Changing Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Turkey in the Last Decade
The Turkish Journal of Gastroenterology
Background: The true prevalence of non-alcoholic fatty liver disease (NAFLD) is unknown in Turkey due to a lack of population-based studies. The aim of this study was (i) to determine the overall and region-specific prevalence of NAFLD in Turkey; (ii) to analyze the factors associated with the prevalence; and (iii) to determine the nationwide change in the prevalence of NAFLD in the last decade. Methods: The 10-year data (2007-2016) of 113 239 apparently healthy subjects visiting the checkup clinics of Acibadem Hospitals Group were retrospectively analyzed. A subgroup of patients (n = 8120) statistically representing the bigger cohort was selected. The prevalence was analyzed according to ultrasound findings, age, sex, body mass index (BMI), geographical region, and time periods tri
Association between nonalcoholic fatty liver disease and coronary artery disease
Coronary Artery Disease, 2007
r e v a s s o c m e d b r a s . 2 0 1 3;5 9(3):290-297 Revista da ASSOCIAÇÃO MÉDICA BRASILEIRA w w w . r a m b . o r g . b r Nonalcoholic fatty liver disease Coronary artery disease a b s t r a c t Objective: Although some investigations have shown a relationship between nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases, there are few studies analyzing the relationship between NAFLD and coronary artery disease (CAD). The aim of this article was to review the relationship between NAFLD and CAD and the methods of diagnosis used to assess such relationship. Methods: A review was performed using search engines of indexed scientific material, including MEDLINE (by PubMed), Web of Science, IBECS, and LILACS, to identify articles published in Portuguese, English, and Spanish until August, 2012. The studies were eligible
2011
Aim: The aim of this study was to review cases of non-alcoholic fatty liver disease cases and to determine the prevalence of non-alcoholic fatty liver disease as a cause of elevated alanine aminotransferase in healthy blood donors in the Permian area and also assess risk factors of NAFLD such as BMI and correlation with metabolic syndrome in these subjects. Background: Non-alcoholic fatty liver disease has been increasingly recognized as the most common pathological conditions affecting the liver. Non-alcoholic fatty liver disease is now recognized as the hepatic component of the metabolic syndrome, which includes hyperlipidemia, glucose intolerance, obesity, and systemic hypertension. Patients and methods: 2002 randomly selected blood donors were recruited for this study. Subjects with elevated serum ALT level (greater than two times the upper limit of normal) were chosen for further follow up. Subjects with a persistently elevated ALT level, evidence of steatosis on computerized tomography and a negative cirrhosis screen (viral hepatitis B and C serology, autoimmune hepatitis, transferrin saturation <45% and a no history of excess alcohol consumption or hepatotoxic medication) were presumed to have non-alcoholic fatty liver disease. Results: 378 donors (20.5% of all subjects recruited) had elevated ALT levels at first measurement. 35 cases had persistently elevated serum ALT level. In 22 of these 35 cases (62.9%) non-alcoholic fatty liver disease was the diagnosis. The mean body mass index of the 22 cases was 31.18 ±5.7 and non-alcoholic fatty liver disease was associated with the metabolic syndrome in these subjects. Conclusion: Non-alcoholic fatty liver disease is the most common diagnosis for subjects with elevated serum ALT level in healthy blood donors in Kerman, Iran.