Nonalcoholic fatty liver disease is associated with coronary artery calcification

• Published in: Hepatology (Baltimore, Md.) Vol. 56; no. 2; pp. 605 - 613
• Main Authors: Kim, Donghee, Choi, Su-Yeon, Park, Eun Ha, Lee, Whal, Kang, Jin Hwa, Kim, Won, Kim, Yoon Jun, Yoon, Jung-Hwan, Jeong, Sook Hyang, Lee, Dong Ho, Lee, Hyo-suk, Larson, Joseph, Therneau, Terry M., Kim, W. Ray
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2012; Wiley; Wolters Kluwer Health, Inc
• Subjects: Age Distribution; Aged; Atherosclerosis; Biological and medical sciences; Calcification; Calcinosis - diagnostic imaging; Calcinosis - epidemiology; Cardiovascular disease; Cholesterol; Confidence intervals; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary vessels; Cross-Sectional Studies; Diabetes; Fatty Liver - diagnostic imaging; Fatty Liver - epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Health risk assessment; Hepatology; Humans; Intra-Abdominal Fat - diagnostic imaging; Liver diseases; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Non-alcoholic Fatty Liver Disease; Other diseases. Semiology; Prevalence; Radiography; Retrospective Studies; Risk Factors; Sex Distribution; Ultrasonography; Calcification; Digestive diseases; Hepatic disease; Non alcoholic steatohepatitis; Coronary artery; Gastroenterology
• ISSN: 0270-9139; 1527-3350; 1527-3350
• DOI: 10.1002/hep.25593

Nonalcoholic fatty liver disease (NAFLD) is related to risk factors of coronary artery disease, such as dyslipidemia, diabetes, and metabolic syndrome, which are closely linked with visceral adiposity. The aim of this study was to investigate whether NAFLD was associated with coronary artery calcification (CAC), which is used as a surrogate marker for coronary atherosclerosis independent of computed tomography (CT)‐measured visceral adiposity. Out of 5,648 subjects who visited one of our health screening centers between 2003 and 2008, we enrolled 4,023 subjects (mean age, 56.9 ± 9.4 years; 60.7% males) without known liver disease or a history of ischemic heart disease. CAC score was evaluated using the Agatston method. On univariate analysis, the presence of CAC (score >0) was significantly associated with age, sex, body mass index, aspartate aminotransferase, alanine aminotransferase, high‐density lipoprotein cholesterol, triglycerides, and increased risk of diabetes, hypertension, smoking, and NAFLD. Increasing CAC scores (0, <10, 10‐100, ≥100) were associated with higher prevalence of NAFLD (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.61‐2.10; P<0.001). Multivariable ordinal regression analysis was adjusted for traditional risk factors, and CT‐measured visceral adipose tissue area in a subgroup of subjects showed that the increased CAC scores were significantly associated with the presence of NAFLD (OR, 1.28, 95% CI, 1.04‐1.59; P = 0.023) independent of visceral adiposity. Conclusion: Patients with NAFLD are at increased risk for coronary atherosclerosis independent of classical coronary risk factors, including visceral adiposity. These data suggest that NAFLD might be an independent risk factor for coronary artery disease. (HEPATOLOGY 2012)