THE HIDDEN RISK: ASSESSING EXTENT OF NON-ALCOHOLIC FATTY LIVER DISEASE AMONG PARTICIPANTS OF THE 2017 HEARTLAND TOUR

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a non-traditional predictor of cardiovascular disease (CVD), however is rarely used in determination of a patient’s overall risk assessment. This project assessed NAFLD scores across Nova Scotia, and compared those values to traditional CV risk factors, body measurements, and activity level. The goal was to determine which values are most strongly correlated with NAFLD, and determine in which patient populations would be most appropriate to obtaining a liver ultrasound during an echocardiography for non-cardiac indications. This project worked in cooperation with The Heartland Tour (HLT), an annual provincial public health campaign in Nova Scotia that promotes active living and a healthy lifestyle to reduce cardiovascular risk. Participants in the HLT enrolled in the study answered a questionnaire around CV risk factors and level of physical activity. Measurements of body composition were made, and a focused ultrasound of 1-2 minutes was taken of their liver. The ultrasounds were later scored by a cardiologist for degree of NAFLD. The results of 174 participants revealed significant differences in NAFLD scores for individuals with higher body fat percentages and higher BMI. Ultrasound did not show significant differences between NAFLD score and gender, family history of CVD, or any single CV risk factor on its own. The data also showed positive correlations between increased NAFLD score and a participant’s age and total number of CV risk factors. There was a protective effect of increased Godin score on NAFLD score, indicated by a negative correlation. As shown by this project, there is a strong association between an individual’s level of NAFLD and specific personal features, age, level of physical activity, and number of CV risk factors. Our data therefore suggests that patients with these features, who are undergoing echocardiography for non-cardiac indications (ie. Syncope), should also have a focused liver scan and analysis of NAFLD. This score would then be combined with other CV risk factors for a more comprehensive assessment of CVD risk and risk management.