DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163293

Association of non-alcoholic fatty liver disease and coronary artery disease

Biswajit Majumder, Viral Tandel, Sandip Ghosh, Sharmistha Chatterjee

Abstract


Background: Nonalcoholic fatty liver disease (NAFLD), a feature of metabolic syndrome is a highly prevalent condition worldwide. Patients with NAFLD have a higher mortality when compared to general population. Many investigators have shown a close relationship between NAFLD and cardiovascular disease which contributes to the total mortality associated with NAFLD particularly in Western population. This study was therefore conducted to evaluate whether NAFLD independently affects angio-graphically proven coronary artery disease in Asians.

Methods: The severity assessment of fatty liver disease was done by ultrasonography and was graded with increased severity from 0 to 4. Coronary angiography was performed to detect the presence or absence of significant coronary artery disease and modified Gensisni score, which determines the severity of coronary atherosclerotic involvement in individual patients was calculated.

Results: Statistical analysis showed that Fatty liver disease was significantly higher in patients with significant coronary artery disease than in non-significant coronary artery disease group. When analyzed on basis on severity of fatty liver disease, modified Gensini score was significantly higher in group with fatty liver grade 2-3 than in group with fatty liver grade 0 or 1. Logistic regression analysis further showed that severity of fatty liver disease had independent effect on coronary atherosclerotic involvement.

Conclusions: From our current study it can be reasonably said that NAFLD may be an independent risk factor for developing arteriosclerosis. This hypothesis should be verified with larger studies in different population groups.


Keywords


Nonalcoholic fatty liver disease, Coronary artery disease, Coronary angiography

Full Text:

PDF

References


Bellentani S, Scaglioni F, Marino M, Bedogni G. Epidemiology of non-alcoholic fatty liver disease. Dig Dis. 2010;28(1):155-61.

Balmer ML, Dufour JF. Non-alcoholic steatohepatitis – from NAFLD to MAFLD. Ther Umsch. 2011;68(4):183-8.

Wong VW, Wong GL, Yip GW, Lo AO, Limquiaco J, Chu WC, et al. Coronary artery disease and cardiovascular outcomes in patients with non-alcoholic fatty liver disease. Gut. 2011;60(12):1721-7.

Tarquini R, Lazzeri C, Boddi M, Marra F, Abbate R, Gensini GF. Non-alcoholic fatty liver disease: a new challenge for cardiologists. G Ital Cardiol (Rome). 2010;11(9):660-9.

Brea A, Mosquera D, Martin E, Arizti A, Cordero JL, Ros E. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: case-control study. Arterioscler Thromb Vasc Biol. 2005;25:1045-50.

Hamaguchi M, Kojima T, Takeda N, Nagata C, Takeda J, Sarui H, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease. World J Gastroenterol. 2007;13:1579-84.

Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis. 2007;191:235-40.

Targher G, Day CP, Bonora E. Risk of cardio vascular disease in patients with non-alcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341-50.

Chitturi S, Farrell GC, Hashimoto E, Saibara T, Lau GK, Sollano JD. Non-alcoholic fatty liver disease in the Asia-Pacific region: definitions and overview of proposed guidelines. J Gastroenterol Hepatol. 2007;22(6):778-7.

Targher G, Bertolini L, Padovani R, Rodella S, Zoppini G, Zenari L, et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care. 2006;29:1325-30.

Edens MA, Kuipers F, Stolk RP. Non-alcoholic fatty liver disease is associated with cardiovascular disease risk markers. Obes Rev. 2009;10:412-9.

Gensini GGMD. The pathological anatomy of the coronary arteries of man. In: Gensini GGMD, ed Coronary arteriography 1975 Mount Kisco, New York Futura Publishing Co. 271-4.

Sullivan DR, Marwick TH, Freedman SB, A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors. Am Heart J. 1990;119:1262-6.

Mark RA, Akihiro N, Anthony K, Jacqui R, Robyn M, Brian PB. Carotid intima-media thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation. 1995;92:2127-34.

Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26- year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67:968-7.

Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8:605-19.

Açikel M, Sunay S, Koplay M, Gündoğdu F, Karakelleoğlu S. Anadolu Kardiyol Derg Fatty liver and coronary atherosclerosis. 2009;9:273-9.

Arslan U, Türkoğlu S, Balcıoğlu S, Tavıl Y, Karakan T, Çengel A. Association between nonalcoholic fatty liver disease and coronary artery disease. Coron Artery Dis. 2007;18:433-6.

Alper AT, Hasdemir H, Sahin S, Onturk E, Akyol A, Nurkalem Z, et al. The relationship between nonalcoholic fatty liver disease and the severity of coronary artery disease in patients with metabolic syndrome. Turk Kardiyol Dern Ars. 2008;36:376-81.

Sun L, Lu S. Association between non-alcoholic fatty liver disease and coronary artery disease severity. Chin Med J. 2011;124:867-72.

Wong VW, Wong GL, Yip GW, Lo AO, Limquiaco J, Chu WC, et al. Coronary artery disease and cardiovascular outcomes in patients with non-alcoholic fatty liver disease. Gut. 2011;60:1721-7.

Aller R, de Luis DA, Fernandez L, Calle F, Velayos B, Olcoz JL, et al. Influence of insulin resistance and adipokines in the grade of steato- sis of nonalcoholic fatty liver disease. Dig Dis Sci. 2008;53:1088-92.

Torres DM, Harrison SA. Diagnosis and therapy of nonal- coholic steatohepatitis. Gastroenterology. 2008;134:1682-98.

Wieckowska A, Zein NN, Yerian LM, Lopez AR, Mc- Cullough AJ, Feldstein AE. In vivo assessment of liver cell apoptosis as a novel biomarker of disease severity in nonal- coholic fatty liver disease. Hepatology 2006;44:27-33.

Yilmaz Y, Dolar E, Ulukaya E, Akgoz S, Keskin M, Kiyici M, et al. Soluble forms of extracellular cytokeratin 18 may differentiate simple steatosis from nonalcoholic steatohepatitis. World J Gastroen- terol. 2007;13:837-44.

Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB. Plasma adiponectin levels and risk of myocar- dial infarction in men. JAMA. 2004;291:1730-7.