Non-alcoholic fatty liver disease and progression of coronary artery calcium score: A retrospective cohort study

Dong Hyun Sinn, Danbee Kang, Yoosoo Chang, Seungho Ryu, Seonhye Gu, Hyunkyoung Kim, Donghyeong Seong, Soo Jin Cho, Byoung Kee Yi, Hyung Doo Park, Seung Woon Paik, Young Bin Song, Mariana Lazo-Elizondo, Joao Lima, Eliseo Guallar, Juhee Cho, Geum Youn Gwak

Research output: Contribution to journalArticle

Abstract

Background and aim Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. Methods This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. Results The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22% (95% CI 20% to 23%) and 17% (16% to 18%), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. Conclusions In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression.

Original languageEnglish (US)
JournalGut
DOIs
StateAccepted/In press - Sep 6 2016

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Disease Progression
Coronary Vessels
Cohort Studies
Retrospective Studies
Calcium
Atherosclerosis
Cardiovascular Diseases
Liver
Fatty Liver
Liver Neoplasms
Non-alcoholic Fatty Liver Disease
Liver Diseases
Coronary Artery Disease
Cross-Sectional Studies
Kidney
Health

ASJC Scopus subject areas

  • Medicine(all)
  • Gastroenterology

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Non-alcoholic fatty liver disease and progression of coronary artery calcium score : A retrospective cohort study. / Sinn, Dong Hyun; Kang, Danbee; Chang, Yoosoo; Ryu, Seungho; Gu, Seonhye; Kim, Hyunkyoung; Seong, Donghyeong; Cho, Soo Jin; Yi, Byoung Kee; Park, Hyung Doo; Paik, Seung Woon; Song, Young Bin; Lazo-Elizondo, Mariana; Lima, Joao; Guallar, Eliseo; Cho, Juhee; Gwak, Geum Youn.

In: Gut, 06.09.2016.

Research output: Contribution to journalArticle

Sinn, DH, Kang, D, Chang, Y, Ryu, S, Gu, S, Kim, H, Seong, D, Cho, SJ, Yi, BK, Park, HD, Paik, SW, Song, YB, Lazo-Elizondo, M, Lima, J, Guallar, E, Cho, J & Gwak, GY 2016, 'Non-alcoholic fatty liver disease and progression of coronary artery calcium score: A retrospective cohort study', Gut. https://doi.org/10.1136/gutjnl-2016-311854
Sinn, Dong Hyun ; Kang, Danbee ; Chang, Yoosoo ; Ryu, Seungho ; Gu, Seonhye ; Kim, Hyunkyoung ; Seong, Donghyeong ; Cho, Soo Jin ; Yi, Byoung Kee ; Park, Hyung Doo ; Paik, Seung Woon ; Song, Young Bin ; Lazo-Elizondo, Mariana ; Lima, Joao ; Guallar, Eliseo ; Cho, Juhee ; Gwak, Geum Youn. / Non-alcoholic fatty liver disease and progression of coronary artery calcium score : A retrospective cohort study. In: Gut. 2016.
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abstract = "Background and aim Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. Methods This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. Results The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22{\%} (95{\%} CI 20{\%} to 23{\%}) and 17{\%} (16{\%} to 18{\%}), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. Conclusions In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression.",
author = "Sinn, {Dong Hyun} and Danbee Kang and Yoosoo Chang and Seungho Ryu and Seonhye Gu and Hyunkyoung Kim and Donghyeong Seong and Cho, {Soo Jin} and Yi, {Byoung Kee} and Park, {Hyung Doo} and Paik, {Seung Woon} and Song, {Young Bin} and Mariana Lazo-Elizondo and Joao Lima and Eliseo Guallar and Juhee Cho and Gwak, {Geum Youn}",
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T1 - Non-alcoholic fatty liver disease and progression of coronary artery calcium score

T2 - A retrospective cohort study

AU - Sinn, Dong Hyun

AU - Kang, Danbee

AU - Chang, Yoosoo

AU - Ryu, Seungho

AU - Gu, Seonhye

AU - Kim, Hyunkyoung

AU - Seong, Donghyeong

AU - Cho, Soo Jin

AU - Yi, Byoung Kee

AU - Park, Hyung Doo

AU - Paik, Seung Woon

AU - Song, Young Bin

AU - Lazo-Elizondo, Mariana

AU - Lima, Joao

AU - Guallar, Eliseo

AU - Cho, Juhee

AU - Gwak, Geum Youn

PY - 2016/9/6

Y1 - 2016/9/6

N2 - Background and aim Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. Methods This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. Results The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22% (95% CI 20% to 23%) and 17% (16% to 18%), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. Conclusions In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression.

AB - Background and aim Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, was associated with subclinical atherosclerosis in many cross-sectional studies, but the prospective association between NAFLD and the progression of atherosclerosis has not been evaluated. This study was conducted to evaluate the association between NAFLD and the progression of coronary atherosclerosis. Methods This retrospective cohort study included 4731 adult men and women with no history of cardiovascular disease (CVD), liver disease or cancer at baseline who participated in a repeated regular health screening examination between 2004 and 2013. Fatty liver was diagnosed by ultrasound based on standard criteria, including parenchymal brightness, liver-to-kidney contrast, deep beam attenuation and bright vessel walls. Progression of coronary artery calcium (CAC) scores was measured using multidetector CT scanners. Results The average duration of follow-up was 3.9 years. During follow-up, the annual rate of CAC progression in participants with and without NAFLD were 22% (95% CI 20% to 23%) and 17% (16% to 18%), respectively (p<0.001). The multivariable ratio of progression rates comparing participants with NAFLD with those without NAFLD was 1.04 (1.02 to 1.05; p<0.001). The association between NAFLD and CAC progression was similar in most subgroups analysed, including in participants with CAC 0 and in those with CAC >0 at baseline. Conclusions In this large cohort study of adult men and women with no history of CVD, NAFLD was significantly associated with the development of CAC independent of cardiovascular and metabolic risk factors. NAFLD may play a pathophysiological role in atherosclerosis development and may be useful to identify subjects with a higher risk of subclinical disease progression.

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U2 - 10.1136/gutjnl-2016-311854

DO - 10.1136/gutjnl-2016-311854

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