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Multicenter Study
. 2015 Aug;63(2):470-6.
doi: 10.1016/j.jhep.2015.02.045. Epub 2015 Mar 14.

Hepatic steatosis and cardiovascular disease outcomes: An analysis of the Framingham Heart Study

Jessica L Mellinger  1 , Karol M Pencina  2 , Joseph M Massaro  3 , Udo Hoffmann  4 , Sudha Seshadri  5 , Caroline S Fox  6 , Christopher J O'Donnell  7 , Elizabeth K Speliotes  8
Affiliations
Multicenter Study

Hepatic steatosis and cardiovascular disease outcomes: An analysis of the Framingham Heart Study

Jessica L Mellinger et al. J Hepatol. 2015 Aug.

Abstract

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.

Keywords: Abdominal aortic calcium; Cardiovascular disease; Coronary artery calcium; Fatty liver.

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Conflict of interest statement

The authors who have taken part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.

Figures

Fig. 1
Fig. 1. Forest plot of odds ratios with 95% confidence intervals for association of non-alcoholic fatty liver disease with clinical and subclinical cardiovascular disease outcomes, stratified by sex
See this image and copyright information in PMC

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