TY - JOUR
T1 - Hepatic steatosis and cardiovascular disease outcomes
T2 - An analysis of the Framingham Heart Study
AU - Mellinger, Jessica L.
AU - Pencina, Karol M.
AU - Massaro, Joseph M.
AU - Hoffmann, Udo
AU - Seshadri, Sudha
AU - Fox, Caroline S.
AU - O'Donnell, Christopher J.
AU - Speliotes, Elizabeth K.
N1 - Publisher Copyright:
© 2015 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.
PY - 2015
Y1 - 2015
N2 - Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent and is associated with development of metabolic disease including atherosclerotic cardiovascular disease (CVD). Our aim is to examine the association of hepatic steatosis with prevalent clinical and subclinical CVD outcomes in a large community-based sample, the Framingham Heart Study. Methods: Hepatic steatosis was measured in 3529 participants using multidetector computed tomography scanning. Multivariable logistic regression was used to determine whether hepatic steatosis is associated with prevalent CVD adjusted for covariates. We also tested whether associations were independent of other metabolic diseases/traits. The primary clinical outcome was composite prevalent clinical CVD defined by prior non-fatal myocardial infarction, stroke, transient ischemic attack, heart failure, or peripheral arterial disease. Subclinical cardiovascular outcomes were coronary artery calcium (CAC) and abdominal artery calcium (AAC). Results: 3014 participants were included (50.5% women). There was a non-significant association of hepatic steatosis with clinical CVD (OR 1.14 [p = 0.07]). Hepatic steatosis was associated with both CAC and AAC (OR 1.20 [p <0.001] and OR 1.16 [p <0.001], respectively). Associations persisted for CAC even when controlling for other risk factors/metabolic diseases, but for AAC, the associations became non-significant after adjustment for visceral adipose tissue. The association between hepatic steatosis and AAC was stronger in men than in women (p sex interaction = 0.022). Conclusion: There was a significant association of hepatic steatosis with subclinical CVD outcomes independent of many metabolic diseases/traits with a trend towards association between hepatic steatosis and clinical CVD outcomes. The association with AAC was stronger in men than in women.
AB - Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent and is associated with development of metabolic disease including atherosclerotic cardiovascular disease (CVD). Our aim is to examine the association of hepatic steatosis with prevalent clinical and subclinical CVD outcomes in a large community-based sample, the Framingham Heart Study. Methods: Hepatic steatosis was measured in 3529 participants using multidetector computed tomography scanning. Multivariable logistic regression was used to determine whether hepatic steatosis is associated with prevalent CVD adjusted for covariates. We also tested whether associations were independent of other metabolic diseases/traits. The primary clinical outcome was composite prevalent clinical CVD defined by prior non-fatal myocardial infarction, stroke, transient ischemic attack, heart failure, or peripheral arterial disease. Subclinical cardiovascular outcomes were coronary artery calcium (CAC) and abdominal artery calcium (AAC). Results: 3014 participants were included (50.5% women). There was a non-significant association of hepatic steatosis with clinical CVD (OR 1.14 [p = 0.07]). Hepatic steatosis was associated with both CAC and AAC (OR 1.20 [p <0.001] and OR 1.16 [p <0.001], respectively). Associations persisted for CAC even when controlling for other risk factors/metabolic diseases, but for AAC, the associations became non-significant after adjustment for visceral adipose tissue. The association between hepatic steatosis and AAC was stronger in men than in women (p sex interaction = 0.022). Conclusion: There was a significant association of hepatic steatosis with subclinical CVD outcomes independent of many metabolic diseases/traits with a trend towards association between hepatic steatosis and clinical CVD outcomes. The association with AAC was stronger in men than in women.
KW - Abdominal aortic calcium
KW - Cardiovascular disease
KW - Coronary artery calcium
KW - Fatty liver
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U2 - 10.1016/j.jhep.2015.02.045
DO - 10.1016/j.jhep.2015.02.045
M3 - Article
C2 - 25776891
AN - SCOPUS:84937056251
SN - 0168-8278
VL - 63
SP - 470
EP - 476
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 2
ER -