A Meta-Analysis on the Global Prevalence, Risk factors and Screening of Coronary Heart Disease in Nonalcoholic Fatty Liver Disease

Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek...

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Published inClinical gastroenterology and hepatology Vol. 20; no. 11; pp. 2462 - 2473.e10
Main Authors Toh, Jonathan Zhi Kai, Pan, Xin-Hui, Tay, Phoebe Wen Lin, Ng, Cheng Han, Yong, Jie Ning, Xiao, Jieling, Koh, Jin Hean, Tan, En Ying, Tan, Eunice Xiang Xuan, Dan, Yock Young, Loh, Poay Huan, Foo, Roger, Chew, Nicholas W.S., Sanyal, Arun J., Muthiah, Mark D., Siddiqui, Mohammad Shadab
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.11.2022
Subjects
Coronary Artery Disease
Coronary Atherosclerosis
Coronary Heart Disease
Gastroenterology and Hepatology
Nonalcoholic Fatty Liver Disease
Steatosis
Coronary Atherosclerosis
CACS
CT
CCTA
NAFLD
Coronary Heart Disease
Nonalcoholic Fatty Liver Disease
CAD
Coronary Artery Disease
CHD
Steatosis
BMI
computed tomography
coronary computed tomography angiography
body mass index
coronary artery calcium scoring
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Abstract Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD. Two databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted. Of the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%–53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%–1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%–67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%–54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%–48.5%) and 55.4% (95% CI, 39.6%–70.1%), respectively. Steatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD. [Display omitted]
AbstractList Background & AimsCardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD. MethodsTwo databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted. ResultsOf the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%–53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%–1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%–67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%–54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%–48.5%) and 55.4% (95% CI, 39.6%–70.1%), respectively. CONCLUSIONSteatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD.
Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD. Two databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted. Of the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%–53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%–1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%–67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%–54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%–48.5%) and 55.4% (95% CI, 39.6%–70.1%), respectively. Steatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD. [Display omitted]
Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD.BACKGROUND & AIMSCardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD.Two databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted.METHODSTwo databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted.Of the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%-53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%-1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%-67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%-54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%-48.5%) and 55.4% (95% CI, 39.6%-70.1%), respectively.RESULTSOf the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%-53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%-1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%-67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%-54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%-48.5%) and 55.4% (95% CI, 39.6%-70.1%), respectively.Steatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD.CONCLUSIONSteatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD.
Author Xiao, Jieling
Toh, Jonathan Zhi Kai
Chew, Nicholas W.S.
Yong, Jie Ning
Ng, Cheng Han
Pan, Xin-Hui
Koh, Jin Hean
Dan, Yock Young
Tan, Eunice Xiang Xuan
Siddiqui, Mohammad Shadab
Tan, En Ying
Foo, Roger
Muthiah, Mark D.
Tay, Phoebe Wen Lin
Loh, Poay Huan
Sanyal, Arun J.
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Issue 11
Keywords Coronary Atherosclerosis
CACS
CT
CCTA
NAFLD
Coronary Heart Disease
Nonalcoholic Fatty Liver Disease
CAD
Coronary Artery Disease
CHD
Steatosis
BMI
computed tomography
coronary computed tomography angiography
body mass index
coronary artery calcium scoring
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Snippet Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of...
Background & AimsCardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the...
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SubjectTerms Coronary Artery Disease
Coronary Atherosclerosis
Coronary Heart Disease
Gastroenterology and Hepatology
Nonalcoholic Fatty Liver Disease
Steatosis
Title A Meta-Analysis on the Global Prevalence, Risk factors and Screening of Coronary Heart Disease in Nonalcoholic Fatty Liver Disease
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