The Prevalence of Non-Alcoholic Fatty Liver Disease Among Patients With and Without Coronary Artery Disease

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a growing diagnosed condition which causes a wide spectrum of liver disorders. There is a lot of evidence introducing NAFLD as a risk factor for coronary artery disease (CAD) but there is substantial challenge on the independency of this correlation. Objectives: The current study aimed to evaluate the prevalence of NAFLD among patients with CAD. Patients and Methods: Patients referred for coronary angiography due to suspected coronary heart disease were included in the study. First, the demographic characteristics were extracted. Alanine aminotransferase (ALT), lipid profile and fasting blood glucose were measured and also liver sonography and coronary angiography were performed on all subjects. According to the angiography results, subjects were divided into three groups: 1- normal angiography; 2-mild CAD and 3- sever CAD. The prevalence of suspected NAFLD was evaluated in all of the groups. Suspected NAFLD was defined as elevated ALT accompanied with fatty liver on liver sonography. Results: A total of 314 subjects were eligible for the study, out of which 161(51.3%) were male and 153 (48.7%) female; 236 (75.1%) subjects had coronary artery disease and 78 (24.9%) subjects had normal coronary arteries. After ranking the subjects according to the degree of coronary artery stenosis; in subjects with normal coronary arteries, 13 subjects (16.7%) were suspected of NAFLD; 172 subjects had mild CAD that 17.44% of them were suspected of NAFLD which was not significant compared to the subjects without CAD (P = 0.046). There was a significant difference in the prevalence of suspected NAFLD among the subjects in the sever CAD group based on finding 64 subjects of NAFLD (P = 0.003). Mean values of total and low-density lipoproteins (LDL) cholesterol, triglyceride and fasting blood sugar (FBS) were significantly greater in subjects with CAD. Subjects with NAFLD had significantly greater means of triglyceride and LDL cholesterol level than subjects without NAFLD (P = 0.03 and 0.0,1 respectively). A significantly greater proportion of subjects in the NAFLD group had hypertriglyceridemia, hypercholesterolemia and low high-density lipoproteins (HDL) level in comparison with the subjects without NAFLD. Conclusions: According to the results of the current study, the prevalence of NAFLD among the subjects with severe CAD was significant; however, further studies are necessary to clarify the importance of the role of NFLD as an independent risk factor for mild CAD.