Nonalcoholic fatty liver disease and vascular function: Cross-sectional analysis in the framingham heart study

Michelle T. Long, Na Wang, Martin G. Larson, Gary F. Mitchell, Joseph Palmisano, Ramachandran S. Vasan, Udo Hoffmann, Elizabeth K. Speliotes, Joseph A. Vita, Emelia J. Benjamin, Caroline S. Fox, Naomi M. Hamburg

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


Objective - Patients with nonalcoholic fatty liver disease (NAFLD) have an increased risk of cardiovascular disease; however, it is not known whether NAFLD contributes to cardiovascular disease independent of established risk factors. We examined the association between NAFLD and vascular function. Approach and Results - We conducted a cross-sectional study of 2284 Framingham Heart Study participants without overt cardiovascular disease who had liver fat attenuation measured on computed tomography and who had measurements of vascular function and covariates. We evaluated the association between NAFLD and vascular function using multivariable partial correlations adjusting for age, sex, cohort, smoking, diabetes mellitus, hyperlipidemia, hypertension, body mass index, and visceral adipose tissue. The prevalence of NAFLD in our sample (mean age, 52±12 years; 51.4% women) was 15.3%. In age-, sex-, and cohort-adjusted analyses, greater liver fat was modestly associated with lower flow-mediated dilation (r=-0.05; P=0.02), lower peripheral arterial tonometry ratio (r=-0.20; P<0.0001), higher carotid-femoral pulse wave velocity (r=0.13; P<0.0001), and higher mean arterial pressure (r=0.11; P<0.0001). In multivariable-adjusted models, NAFLD remained associated with higher mean arterial pressure (r=0.06; P=0.005) and lower peripheral arterial tonometry ratio (r=-0.12; P<0.0001). The association between NAFLD and peripheral arterial tonometry ratio persisted after further adjustment for body mass index and visceral adipose tissue. Conclusions - For multiple measures of vascular function, the relationship with NAFLD appeared largely determined by shared cardiometabolic risk factors. The persistent relationship with reduced peripheral arterial tonometry response beyond established risk factors suggests that NAFLD may contribute to microvascular dysfunction.

Original languageEnglish (US)
Pages (from-to)1284-1291
Number of pages8
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Issue number5
StatePublished - May 27 2015
Externally publishedYes


  • multidetector computed tomography
  • obesity
  • risk factors
  • vascular endothelium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Nonalcoholic fatty liver disease and vascular function: Cross-sectional analysis in the framingham heart study'. Together they form a unique fingerprint.

Cite this