Clinical significance of hepatic steatosis according to coronary plaque morphology: assessment using controlled attenuation parameter

• Published in: Journal of gastroenterology Vol. 54; no. 3; pp. 271 - 280
• Main Authors: Park, Hyo Eun, Lee, Heesun, Choi, Su-Yeon, Kwak, Min-Sun, Yang, Jong In, Yim, Jeong Yoon, Chung, Goh Eun
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2019; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Arteriosclerosis; Atherosclerosis; Biliary Tract; Calcification; Clinical significance; Colorectal Surgery; Computed tomography; Fatty liver; Gastroenterology; Hepatology; Liver; Liver diseases; Medical screening; Medicine; Medicine & Public Health; Original Article—Liver; Pancreas; Plaques; Risk factors; Steatosis; Surgical Oncology; Controlled attenuation parameter; FibroScan; NAFLD; Coronary plaque
• ISSN: 0944-1174; 1435-5922; 1435-5922
• DOI: 10.1007/s00535-018-1516-5

Background Nonalcoholic fatty liver disease (NAFLD) plays a significant role in coronary atherosclerosis, independent of shared metabolic risk factors. The measurement of the controlled attenuation parameter (CAP) has shown to allow early and noninvasive detection of NAFLD at subclinical stage. We evaluated the significance of CAP-defined NAFLD in association with the presence of any type of coronary plaques and different plaque compositions. Methods We conducted a retrospective cohort of apparently healthy subjects who had liver Fibroscan and coronary computed tomography during health screening exams. Results A greater number of subjects with CAP-defined NAFLD was found in group with coronary plaques (61.3% vs. 73.5%, p  = 0.005 without vs. with any type of plaque). From multivariate regression model, CAP ≥ 222 dB/m was an independent and significant parameter associated with the presence of coronary plaques, after adjusting possible confounders (OR 1.624, 95% 1.047–2.518, p  = 0.030). Interestingly, CAP ≥ 222 dB/m was significantly associated with non-calcified plaque (adjusted OR 3.528, 95% CI 1.463–8.511, p  = 0.005), whereas it was not significant in calcified plaques ( p  = 0.171). Conclusion CAP-defined NAFLD is independently associated with coronary plaques, especially non-calcified plaques. The association between NAFLD and non-calcified plaques suggests that particular attention should be given to the subjects with NAFLD for primary prevention.