Potential conflict of interest: Nothing to report.
Steatohepatitis/Metabolic Liver Disease
Article first published online: 2 JUL 2012
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 56, Issue 2, pages 605–613, August 2012
How to Cite
Kim, D., Choi, S.-Y., Park, E. H., Lee, W., Kang, J. H., Kim, W., Kim, Y. J., Yoon, J.-H., Jeong, S. H., Lee, D. H., Lee, H.-s., Larson, J., Therneau, T. M. and Kim, W. R. (2012), Nonalcoholic fatty liver disease is associated with coronary artery calcification. Hepatology, 56: 605–613. doi: 10.1002/hep.25593
Supported by grant 04-2009-055 from the Seoul National University Hospital Research Fund.
The funding organizations had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
- Issue published online: 25 JUL 2012
- Article first published online: 2 JUL 2012
- Accepted manuscript online: 23 JAN 2012 06:12AM EST
- Manuscript Accepted: 26 DEC 2011
- Manuscript Received: 25 AUG 2011
Nonalcoholic fatty liver disease (NAFLD) is related to risk factors of coronary artery disease, such as dyslipidemia, diabetes, and metabolic syndrome, which are closely linked with visceral adiposity. The aim of this study was to investigate whether NAFLD was associated with coronary artery calcification (CAC), which is used as a surrogate marker for coronary atherosclerosis independent of computed tomography (CT)-measured visceral adiposity. Out of 5,648 subjects who visited one of our health screening centers between 2003 and 2008, we enrolled 4,023 subjects (mean age, 56.9 ± 9.4 years; 60.7% males) without known liver disease or a history of ischemic heart disease. CAC score was evaluated using the Agatston method. On univariate analysis, the presence of CAC (score >0) was significantly associated with age, sex, body mass index, aspartate aminotransferase, alanine aminotransferase, high-density lipoprotein cholesterol, triglycerides, and increased risk of diabetes, hypertension, smoking, and NAFLD. Increasing CAC scores (0, <10, 10-100, ≥100) were associated with higher prevalence of NAFLD (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.61-2.10; P<0.001). Multivariable ordinal regression analysis was adjusted for traditional risk factors, and CT-measured visceral adipose tissue area in a subgroup of subjects showed that the increased CAC scores were significantly associated with the presence of NAFLD (OR, 1.28, 95% CI, 1.04-1.59; P = 0.023) independent of visceral adiposity. Conclusion: Patients with NAFLD are at increased risk for coronary atherosclerosis independent of classical coronary risk factors, including visceral adiposity. These data suggest that NAFLD might be an independent risk factor for coronary artery disease. (HEPATOLOGY 2012)