Dong Hyun Sinn1, Danbee Kang2, Yoosoo Chang3,4,5, Seungho Ryu3,4,5, Seonhye Gu6, Hyunkyoung Kim6, Donghyeong Seong2, Soo Jin Cho7, Byoung-Kee Yi2,8, Hyung-Doo Park9, Seung Woon Paik1, Young Bin Song1,10, Mariana Lazo10, Joao A C Lima10, Eliseo Guallar10, Juhee Cho2,3,5,10, Geum-Youn Gwak1. 1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 2. Department of Health Science and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea. 3. Center for Cohort Studies, Total Healthcare Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea. 4. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea. 5. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. 6. Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 7. Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 8. Department of Medical Informatics, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 9. Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 10. Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, USA.
Abstract
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. METHODS: This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. RESULTS: The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22% (95% CI 20% to 23%) and 17% (16% to 18%), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. CONCLUSIONS: In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. METHODS: This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. RESULTS: The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22% (95% CI 20% to 23%) and 17% (16% to 18%), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. CONCLUSIONS: In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Robert M Wilechansky; Alison Pedley; Joseph M Massaro; Udo Hoffmann; Emelia J Benjamin; Michelle T Long Journal: Liver Int Date: 2019-05-24 Impact factor: 5.828
Authors: Zachary P Fricker; Alison Pedley; Joseph M Massaro; Ramachandran S Vasan; Udo Hoffmann; Emelia J Benjamin; Michelle T Long Journal: Clin Gastroenterol Hepatol Date: 2018-11-23 Impact factor: 11.382
Authors: Neal S Parikh; Nicole Dueker; Dalila Varela; Victor J Del Brutto; Tatjana Rundek; Clinton B Wright; Ralph L Sacco; Mitchell S V Elkind; Jose Gutierrez Journal: J Neurol Sci Date: 2020-06-20 Impact factor: 3.181