Non-Alcoholic Fatty Liver Disease with and without Metabolic Syndrome: Different Long-term Outcomes

• Published in: Metabolism, clinical and experimental Vol. 66; pp. 55 - 63
• Main Authors: Käräjämäki, Aki Juhani, Bloigu, Risto, Kauma, Heikki, Kesäniemi, Y. Antero, Koivurova, Olli-Pekka, Perkiömäki, Juha, Huikuri, Heikki, Ukkola, Olavi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Adult; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Case-Control Studies; Disease Progression; Endocrinology & Metabolism; Female; Humans; Male; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Middle Aged; Non-alcoholic fatty liver disease; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Prevalence; Prognosis; Risk Factors; Time Factors; Type 2 diabetes; NAFLD; non-alcoholic fatty liver disease; ICD-10; LVMI; International Statistical Classification of Diseases and Related Health Problems; IDF; HR; hazards ratio; left ventricular mass index; OPERA Study; Oulu Project Elucidating Risk of Atherosclerosis study; ANCOVA; analysis of variance; ANOVA; BMI; International Diabetes Federation; coronary artery bypass grafting; WHO; World Health Organization; body mass index; T2D; cardiovascular diseases; metabolic syndrome; CVD; type 2 diabetes; MetS; left ventricular hypertrophy; subarachnoid hemorrhage; PNPLA3; coronary heart disease; SAH; CABG; analysis of covariance; CHD; patatin-like phospholipase domain-containing 3 gene; LVH; Type 2 diabetes; Metabolic syndrome; Non-alcoholic fatty liver disease; Cardiovascular diseases
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2016.06.009

Abstract Background Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are both shown to increase the risk of cardiovascular diseases and type 2 diabetes. However, there is a great overlap between these two diseases. The present study was aimed to examine the cardiovascular and metabolic prognosis of non-alcoholic fatty liver disease with and without metabolic syndrome. Methods Middle-aged subjects (n = 958) were divided into four subgroups, those with NAFLD and MetS, those with NAFLD or MetS, and healthy controls. The baseline characteristics of the subgroups were analyzed. The follow-up time for cardiovascular events was about 16 years. After approximately 21 years the cardiac ultrasound and laboratory parameters were re-analyzed and new type 2 diabetes cases were recorded. Results Those with both diseases were at the greatest risk for cardiovascular events (p < 0.001). Compared to healthy controls, only those with MetS, with or without NAFLD, were at increased risk for the development of type 2 diabetes (p < 0.001) and for an increase in left ventricular mass index (p = 0.001 and p = 0.005, respectively). The cardiovascular and metabolic risk in subjects with NAFLD only was quite similar to that in healthy controls. The I148M variant of the patatin-like phospholipase domain-containing 3 gene (PNPLA3 polymorphism) was most present in those with NAFLD only (p = 0.008). Conclusions NAFLD with MetS implies a considerable risk for cardiovascular diseases, type 2 diabetes and the increase of left ventricular mass index whereas NAFLD without MetS does not.