Abstract P447: Association Between Cardiovascular Health (CVH) Throughout Early Adulthood With Prevalent Non-Alcoholic Fatty Liver Disease (NAFLD) in Mid-Life: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is associated with high prevalence of cardiovascular disease and its risk factors. More favorable cardiovascular health (CVH) profiles are associated with a lower prevalence of NAFLD in cross-sectional studies. However, the relationship between long-term CVH patterns in early adulthood and prevalence of NAFLD in midlife remains unknown. We aimed to assess these patterns. Methods: We used data from participants (18-30 years at baseline) of the CARDIA study who had individual CVH components measured at 7 examinations over 20 years and liver fat assessed by non-contrast computed tomography (CT) at year 25 follow up. Group-based trajectory modeling was used to create CVH trajectories, according to American Heart Association definitions, from baseline through follow-up year 20. NAFLD was defined as liver attenuation of < 51 HU after exclusions. Dichotomous logistic regression was used to examine associations of baseline CVH scores (n=2618) or CVH trajectory group (n=2529) and prevalence of NAFLD at year 25. Results: At baseline, 39% of 2618 participants had high and 5% had low CVH, respectively. At year 25, NAFLD prevalence was 23% (n = 609). At year 25, compared to those without NAFLD, participants with NAFLD were more likely be male (54.2% vs. 37.3%) and be a current smoker (27.1% vs. 21.7%) at baseline. Participants with low (HR = 3.24, 95% CI = 2.13, 4.95) and moderate (HR = 1.85, 95% CI = 1.50, 2.29) CVH scores at baseline were more likely to have a higher risk of prevalent NAFLD compared to participants with high CVH scores. Five distinct trajectories of CVH were identified. Lower and decreasing trajectories were associated with higher risk of prevalent NAFLD at year 25 compared to the high stable trajectory (Figure). Conclusion: Low CVH scores in young adulthood and low and decreasing CVH trajectories throughout early adulthood are associated with higher prevalence of NAFLD in midlife. Optimizing CVH in early adulthood is critical for lowering risk for prevalent NAFLD in midlife.