Seung Bum Lee1, Gyung-Min Park2, Jong-Young Lee3, Byung Uk Lee1, Jae Ho Park1, Byung Gyu Kim1, Seok Won Jung1, In Du Jeong1, Sung-Jo Bang1, Jung Woo Shin1, Neung Hwa Park1, Dong Hyun Yang4, Joon-Won Kang4, Tae-Hwan Lim4, Hong-Kyu Kim5, Jaewon Choe5, Han Chu Lee6. 1. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. 2. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. Electronic address: min8684@hanmail.net. 3. Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea. Electronic address: jyleeheart@naver.com. 4. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 5. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 6. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND & AIMS: There are limited data on the association between non-alcoholic fatty liver disease (NAFLD) and subclinical coronary atherosclerosis. This study investigated the influence of NAFLD on subclinical coronary atherosclerosis as detected by coronary computed tomography angiography (CCTA) in an asymptomatic population. METHODS: A total of 5,121 consecutive asymptomatic individuals with no prior history of coronary artery disease or significant alcohol intake voluntarily underwent abdominal ultrasonography and CCTA as part of a general health examination. Fatty liver was assessed by ultrasonography examination. The fatty liver index and NAFLD fibrosis score were also calculated. Coronary atherosclerotic plaques on CCTA were evaluated. The association between NAFLD and subclinical coronary atherosclerosis was determined by logistic regression analysis. RESULTS: Of the study participants, 1,979 (38.6%) had ultrasonography-diagnosed NAFLD. After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios of NAFLD for calcified plaque (1.03; 95% CI 0.89-1.20; p = 0.673) and mixed plaque (1.15; 95% CI 0.93-1.42; p = 0.214). However, adjusted odds ratios for any atherosclerotic plaque (1.18; 95% CI 1.03-1.35; p = 0.016) and non-calcified plaque (1.27; 95% CI 1.08-1.48; p = 0.003) were significantly higher in NAFLD. In addition, there was a significant association of fatty liver index ≥30 with non-calcified plaque (1.37; 95% CI 1.14-1.65; p = 0.001) and NAFLD fibrosis score ≥-1.455 with non-calcified plaque (1.20; 95% CI 1.08-1.42; p = 0.030). CONCLUSIONS: In this large cross-sectional study of asymptomatic individuals undergoing CCTA, NAFLD was consistently associated with non-calcified plaque, suggesting an increased cardiovascular risk. LAY SUMMARY: In asymptomatic individuals, non-alcoholic fatty liver disease (NAFLD) was an independent risk factor for non-calcified plaque, which has been known as a vulnerable plaque associated with sudden and unexpected cardiac events. Therefore, appropriate medical therapy for NAFLD was required to reduce future cardiac events.
BACKGROUND & AIMS: There are limited data on the association between non-alcoholic fatty liver disease (NAFLD) and subclinical coronary atherosclerosis. This study investigated the influence of NAFLD on subclinical coronary atherosclerosis as detected by coronary computed tomography angiography (CCTA) in an asymptomatic population. METHODS: A total of 5,121 consecutive asymptomatic individuals with no prior history of coronary artery disease or significant alcohol intake voluntarily underwent abdominal ultrasonography and CCTA as part of a general health examination. Fatty liver was assessed by ultrasonography examination. The fatty liver index and NAFLD fibrosis score were also calculated. Coronary atherosclerotic plaques on CCTA were evaluated. The association between NAFLD and subclinical coronary atherosclerosis was determined by logistic regression analysis. RESULTS: Of the study participants, 1,979 (38.6%) had ultrasonography-diagnosed NAFLD. After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios of NAFLD for calcified plaque (1.03; 95% CI 0.89-1.20; p = 0.673) and mixed plaque (1.15; 95% CI 0.93-1.42; p = 0.214). However, adjusted odds ratios for any atherosclerotic plaque (1.18; 95% CI 1.03-1.35; p = 0.016) and non-calcified plaque (1.27; 95% CI 1.08-1.48; p = 0.003) were significantly higher in NAFLD. In addition, there was a significant association of fatty liver index ≥30 with non-calcified plaque (1.37; 95% CI 1.14-1.65; p = 0.001) and NAFLD fibrosis score ≥-1.455 with non-calcified plaque (1.20; 95% CI 1.08-1.42; p = 0.030). CONCLUSIONS: In this large cross-sectional study of asymptomatic individuals undergoing CCTA, NAFLD was consistently associated with non-calcified plaque, suggesting an increased cardiovascular risk. LAY SUMMARY: In asymptomatic individuals, non-alcoholic fatty liver disease (NAFLD) was an independent risk factor for non-calcified plaque, which has been known as a vulnerable plaque associated with sudden and unexpected cardiac events. Therefore, appropriate medical therapy for NAFLD was required to reduce future cardiac events.
Authors: Jessica Carter; Thomas D Heseltine; Mohammed N Meah; Evangelos Tzolos; Jacek Kwiecinski; Mhairi Doris; Priscilla McElhinney; Alastair J Moss; Philip D Adamson; Amanda Hunter; Shirjel Alam; Anoop S V Shah; Tania Pawade; Chengjia Wang; Jonathan R Weir-McCall; Giles Roditi; Edwin J R van Beek; Edward D Nicol; Leslee J Shaw; Daniel S Berman; Piotr J Slomka; Nicholas L Mills; Marc R Dweck; David E Newby; Scott W Murray; Damini Dey; Michelle C Williams Journal: Radiol Cardiothorac Imaging Date: 2022-04-28
Authors: Constanze Bardach; Leonie Morski; Katharina Mascherbauer; Carolina Donà; Matthias Koschutnik; Kseniya Halavina; Christian Nitsche; Dietrich Beitzke; Christian Loewe; Elisabeth Waldmann; Michael Trauner; Julia Mascherbauer; Christian Hengstenberg; Andreas Kammerlander Journal: J Clin Med Date: 2022-05-19 Impact factor: 4.964
Authors: Tomas Vita; David J Murphy; Michael T Osborne; Navkaranbir S Bajaj; Abhishek Keraliya; Sophia Jacob; Angel Joel Diaz Martinez; Ariana Nodoushani; Paco Bravo; Jon Hainer; Courtney F Bibbo; Michael L Steigner; Viviany R Taqueti; Hicham Skali; Ron Blankstein; Marcelo F Di Carli; Sharmila Dorbala Journal: Radiology Date: 2019-03-05 Impact factor: 29.146
Authors: Negar Sarmadi; Hossein Poustchi; Fatemeh Ali Yari; Amir Reza Radmard; Sara Karami; Abbas Pakdel; Parisa Shabani; Ali Khaleghian Journal: PLoS One Date: 2022-04-12 Impact factor: 3.240