Sharon S Brouha1, Phirum Nguyen2,3, Ricki Bettencourt2,3,4, Claude B Sirlin3, Rohit Loomba2,3,4. 1. Department of Radiology, University of California at San Diego, 200 W. Arbor Drive #8756, La Jolla, San Diego, CA, 92103, USA. sbrouha@ucsd.edu. 2. NAFLD Research Center and Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA. 3. Liver Imaging Group, Department of Radiology, University of California, San Diego, La Jolla, CA, USA. 4. Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
Abstract
OBJECTIVES: To determine whether severity of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis quantitatively assessed in individuals with diabetes mellitus (DM)-2 correlate with increased coronary heart disease (CHD) risk using non-invasive markers. METHODS: We conducted a single-centre, prospective, cross-sectional study in 100 consecutive diabetic individuals without known CHD recruited between March 2013 and September 2014. History, physical examination, serum markers, cardiac computed tomography (CT), magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) and MR elastography (MRE) were obtained for 95 participants. Written informed consent was provided. Institutional review board approved this study. Spearman rank correlation was performed to assess for correlations. Multiple linear regression model determined independent predictors of epicardial adipose tissue (EAT) volume. RESULTS: A p value < 0.05 determined statistical significance. The EAT volume was higher in the NAFLD group, defined as MR-imaging PDFF ≥ 5 %, compared to the non-NAFLD group (126.5 ml (IQR 80.9) versus 85.4 ml (IQR 44.7), p=0.002). MR imaging-PDFF correlated with EAT (r=0.42, p < 0.0001). MR imaging-PDFF and liver fibrosis were independently associated with EAT. CONCLUSIONS: Higher liver fat content and liver fibrosis may portend worse cardiovascular risk in diabetics. KEY POINTS: • EAT volume is higher in diabetic individuals with NAFLD. • Liver fat content is positively correlated with EAT. • Liver fat content and liver fibrosis were independently associated with EAT. • Higher liver fat content and fibrosis may adversely affect cardiovascular risk.
OBJECTIVES: To determine whether severity of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis quantitatively assessed in individuals with diabetes mellitus (DM)-2 correlate with increased coronary heart disease (CHD) risk using non-invasive markers. METHODS: We conducted a single-centre, prospective, cross-sectional study in 100 consecutive diabetic individuals without known CHD recruited between March 2013 and September 2014. History, physical examination, serum markers, cardiac computed tomography (CT), magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) and MR elastography (MRE) were obtained for 95 participants. Written informed consent was provided. Institutional review board approved this study. Spearman rank correlation was performed to assess for correlations. Multiple linear regression model determined independent predictors of epicardial adipose tissue (EAT) volume. RESULTS: A p value < 0.05 determined statistical significance. The EAT volume was higher in the NAFLD group, defined as MR-imaging PDFF ≥ 5 %, compared to the non-NAFLD group (126.5 ml (IQR 80.9) versus 85.4 ml (IQR 44.7), p=0.002). MR imaging-PDFF correlated with EAT (r=0.42, p < 0.0001). MR imaging-PDFF and liver fibrosis were independently associated with EAT. CONCLUSIONS: Higher liver fat content and liver fibrosis may portend worse cardiovascular risk in diabetics. KEY POINTS: • EAT volume is higher in diabetic individuals with NAFLD. • Liver fat content is positively correlated with EAT. • Liver fat content and liver fibrosis were independently associated with EAT. • Higher liver fat content and fibrosis may adversely affect cardiovascular risk.
Authors: Amir A Mahabadi; Marie H Berg; Nils Lehmann; Hagen Kälsch; Marcus Bauer; Kaffer Kara; Nico Dragano; Susanne Moebus; Karl-Heinz Jöckel; Raimund Erbel; Stefan Möhlenkamp Journal: J Am Coll Cardiol Date: 2013-02-20 Impact factor: 24.094
Authors: Amir A Mahabadi; Nils Lehmann; Hagen Kälsch; Tim Robens; Marcus Bauer; Iryna Dykun; Thomas Budde; Susanne Moebus; Karl-Heinz Jöckel; Raimund Erbel; Stefan Möhlenkamp Journal: JACC Cardiovasc Imaging Date: 2014-09
Authors: Rajiv Chhabra; James H O'Keefe; Harshal Patil; Evan O'Keefe; Randall C Thompson; Shaya Ansari; Kevin F Kennedy; Linda W Lee; John H Helzberg Journal: Mayo Clin Proc Date: 2013-10-16 Impact factor: 7.616
Authors: Yingzhen N Zhang; Kathryn J Fowler; Gavin Hamilton; Jennifer Y Cui; Ethan Z Sy; Michelle Balanay; Jonathan C Hooker; Nikolaus Szeverenyi; Claude B Sirlin Journal: Br J Radiol Date: 2018-06-06 Impact factor: 3.039