Abstract
ObjectivesThis study aims to estimate the relationship between non-alcoholic fatty liver disease (NAFLD) and measures of atherosclerotic cardiovascular disease (ASCVD), and to determine to what extent such relationships are modified by metabolic risk factors.MethodsThe study was conducted in the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot cohort (n = 1015, age 50–64 years, 51.2% women). NAFLD was defined as computed tomography liver attenuation ≤40 Hounsfield Units, excluding other causes of liver fat. Coronary artery calcification score (CACS) was assessed using the Agatston method. Carotid plaques and intima media thickness (IMT) were measured by ultrasound. Metabolic status was based on assessments of glucose homeostasis, serum lipids, blood pressure and inflammation. A propensity score model was used to balance NAFLD and non NAFLD groups with regards to potential confounders and associations between NAFLD status and ASCVD variables in relation to metabolic status were examined by logistic and generalized linear regression models.ResultsNAFLD was present in 106 (10.4%) of the subjects and strongly associated with obesity-related traits. NAFLD was significantly associated with CACS after adjustment for confounders and metabolic risk factors (OR 1.77, 95% CI 1.07–2.94), but not with carotid plaques and IMT. The strongest association between NAFLD and CACS was observed in subjects with few metabolic risk factors (n = 612 [60% of all] subjects with 0–1 out of 7 predefined metabolic risk factors; OR 5.94, 95% CI 2.13–16.6).ConclusionsNAFLD was independently associated with coronary artery calcification but not with measures of carotid atherosclerosis in this cohort. The association between NAFLD and CACS was most prominent in the metabolically healthy subjects.
Highlights
Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of liver conditions ranging from isolated fatty liver to fatty liver along with inflammation
NAFLD was significantly associated with calcification score (CACS) after adjustment for confounders and metabolic risk factors, but not with carotid plaques and intima media thickness (IMT)
The strongest association between NAFLD and CACS was observed in subjects with few metabolic risk factors (n = 612 [60% of all] subjects with 0–1 out of 7 predefined metabolic risk factors; odds ratios (OR) 5.94, 95% confidence intervals (CI) 2.13–16.6)
Summary
Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of liver conditions ranging from isolated fatty liver (steatosis) to fatty liver along with inflammation (i.e. non-alcoholic steatohepatitis [NASH]). Most NAFLD patients display other obesity-related metabolic aberrations such as impaired glucose homeostasis, dyslipidemia, hypertension, and low-grade inflammation [2] These metabolic risk factors could potentially explain the increased incidence of ASCVD in NAFLD patients and current clinical practice guidelines for the management of NAFLD recommends that all individuals with steatosis should be screened for features of the metabolic syndrome (MetS) [18]. Given the central role of metabolic risk factors in the management of NAFLD, it is important to understand how these factors modify the relationship between NAFLD and ASCVD and to assess cardiovascular risk for patients who appear metabolically unaffected by their NAFLD as judged from clinical parameters.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
