Abstract
BackgroundNonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome). We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT).MethodsThis retrospective study involved 414 participants suspected of having coronary artery disease. Nonalcoholic hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 and the presence and appropriate characteristics of coronary-artery plaques as assessed by coronary CT angiography. High-risk plaques were identified, as were low-density plaques, positive remodeling, and spotty calcification.ResultsCompared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p<0.01), positive remodeling (41% vs. 58%, p = 0.01), and spotty calcification (12% vs. 36%, p<0.01). The number of high-risk plaques in patients with nonalcoholic hepatic steatosis was greater than in those without nonalcoholic hepatic steatosis (p<0.01). Patients with nonalcoholic hepatic steatosis were more likely to have high-risk plaques than were those with only an elevated level of visceral adipose tissue (≥86 cm2; 35% vs. 16%, p<0.01). Multivariate analyses that included nonalcoholic hepatic steatosis, amount of visceral adipose tissue, and the presence/absence of traditional risk factors demonstrated that nonalcoholic hepatic steatosis was an independent predictor of high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94–9.07, p<0.01).ConclusionsDiagnosis of nonalcoholic hepatic steatosis may be of value when assessing the risk of coronary artery disease.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of abnormal liver function, as documented in an urban population in the USA [1]
We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT)
Compared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p
Summary
Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of abnormal liver function, as documented in an urban population in the USA [1]. NAFLD is associated with several systemic diseases (e.g., visceral obesity, type-2 diabetes mellitus, dyslipidemia, hypertension), all of which are typical manifestations of the metabolic syndrome [2]. Visceral adipose tissue (VAT) has been shown to be independently associated with metabolic syndrome, diabetes mellitus, coronary artery disease (CAD), and CAD-related deaths [2]. NAFLD has been associated with coronary plaques [4] even in the arteries of patients who do not have metabolic syndrome [12]. Nonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome). We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT)
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