Non-Alcoholic Fatty Liver Disease Is an Independent Risk Factor for LDL Cholesterol Target Level.

Jun-Hyuk Lee,Yu-Jin Kwon,Hye Sun Lee,Yong-Jae Lee,A-Ra Cho

doi:10.3390/ijerph18073442

Abstract

Although patients with non-alcoholic fatty liver disease (NAFLD) face a higher risk of cardiovascular disease (CVD), it is not known whether people with NAFLD are less likely to achieve optimal management of low-density lipoprotein (LDL) cholesterol than those without NAFLD. We aimed to investigate the longitudinal effect of NAFLD on the management of LDL cholesterol in 5610 adults from the Korean Genome and Epidemiology Study. Participants were classified into NAFLD and normal groups. Non-achievement of the target LDL cholesterol level was set according to one’s cardiovascular disease (CVD) risk level. The estimated proportion of individuals who did not achieve their LDL cholesterol targets was higher in the NAFLD group than in the normal group during the follow-up period of 12 years in a generalized estimation equation model. Multivariable Cox regression analysis revealed a hazard ratio and 95% confidence interval for incident non-achievement of one’s LDL cholesterol target of 1.196 (1.057–1.353) in the NAFLD group (p = 0.005). We found that NAFLD was significantly related to non-achievement of LDL cholesterol targets in this prospective cohort study. Prevention and proper management of NAFLD have important health implications for the prevention of CVD.

Highlights

Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide [1]
In this study, we aimed to investigate the effect of non-alcoholic fatty liver disease (NAFLD) on the manageTherefore, in this study, we aimed to investigate the effect of NAFLD on the management of low-density lipoprotein (LDL) cholesterol based on one’s cardiovascular disease (CVD) risk
Levels, homeostasis assessment model of insulin resistance (HOMA-IR); and changes in LDL cholesterol level per year were significantly higher in the NAFLD group than in the normal group

Summary

Introduction

Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide [1]. Of all deaths (17.9 million people) stemmed from CVD in 2016 [2]. Risk factors for CVD can be classified into non-modifiable and modifiable risk factors. Non-modifiable risk factors include age, sex, ethnicity, and family history of premature coronary artery disease; modifiable risk factors include smoking, diabetes, high blood pressure, obesity, physical inactivity, and high blood cholesterol. Individuals who are at high risk or have already experienced CVD are recommended to manage modifiable CVD risk factors, including behavioral factors [3,4,5]. Among the modifiable metabolic risk factors, low-density lipoprotein (LDL) cholesterol is a well-known risk factor for the development of atherosclerosis [6]

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