Cardiovascular Risk Is Elevated in Lean Subjects with Nonalcoholic Fatty Liver Disease

• Published in: Gut and liver Vol. 16; no. 2; pp. 290 - 299
• Main Authors: Kim, Yuna, Han, Eugene, Lee, Jae Seung, Lee, Hye Won, Kim, Beom Kyung, Kim, Mi Kyung, Kim, Hye Soon, Park, Jun Yong, Kim, Do Young, Ahn, Sang Hoon, Lee, Byung-Wan, Kang, Eun Seok, Cha, Bong-Soo, Lee, Yong-ho, Kim, Seung Up
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 15.03.2022; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Body Mass Index; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; cardiovascular risk; fatty liver; Heart Disease Risk Factors; Humans; lean; Liver - pathology; Liver Cirrhosis - complications; liver fibrosis; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - epidemiology; nonalcoholic fatty liver disease; Obesity - complications; Original; Risk Factors; 내과학; Lean; Nonalcoholic fatty liver disease; Fatty liver; Liver fibrosis; Cardiovascular risk
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl210084

: Nonalcoholic fatty liver disease (NAFLD) and obesity are independently associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD), the leading cause of mortality in patients with NAFLD. Many NAFLD patients are lean, but their ASCVD risk compared to obese subjects with NAFLD is unclear. Data from the 2008 to 2011 Korea National Health and Nutrition Examination Surveys database were analyzed (n=4,786). NAFLD was defined as a comprehensive NAFLD score ≥40 or a liver fat score ≥-0.640. ASCVD risk was evaluated using the American College of Cardiology/ American Heart Association guidelines. The frequency of subjects without NAFLD, with obese NAFLD, and with lean NAFLD was 62.4% (n=2,987), 26.6% (n=1,274), and 11.0% (n=525), respectively. Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of a high ASCVD risk (mean 15.6±14.0, 51.6%) than those with obese NAFLD and without NAFLD (mean 11.2±11.4, 39.8%; mean 7.9±10.9, 25.5%; all p<0.001). Subjects with lean NAFLD and significant liver fibrosis showed a significantly higher odds ratio for a high risk for ASCVD than those with obese NAFLD with or without significant liver fibrosis (odds ratio, 2.60 vs 1.93; p=0.023). Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of high risk for ASCVD than those with obese NAFLD. Similarly, lean subjects with significant liver fibrosis had a higher probability of ASCVD than obese subjects in the subpopulation with NAFLD.