Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Sep 16:6:33386.
doi: 10.1038/srep33386.

Association of non-alcoholic fatty liver disease with major adverse cardiovascular events: A systematic review and meta-analysis

Shunquan Wu  1 , Fuquan Wu  2 , Yingying Ding  3 , Jun Hou  1 , Jingfeng Bi  1 , Zheng Zhang  1
Affiliations
Meta-Analysis

Association of non-alcoholic fatty liver disease with major adverse cardiovascular events: A systematic review and meta-analysis

Shunquan Wu et al. Sci Rep. .

Abstract

Increasing evidence connects non-alcoholic fatty liver disease (NAFLD) to cardiovascular disease (CVD). The aim of this study is to assess whether and to what extent the excess risk of CVD is conferred by NAFLD in a meta-analysis. We systematically searched PubMed, EmBase, Web of Science, and Cochrane Library for reports published between 1965 and July 3, 2015. Studies that reported data on association between NAFLD and adverse cardiovascular events or mortality were included. Thirty-four studies (164,494 participants, 21 cross-sectional studies, and 13 cohort studies) were included. NAFLD was not associated with overall mortality (HR = 1.14, 95% CI: 0.99-1.32) and CVD mortality (HR = 1.10, 95% CI: 0.86-1.41). However, NAFLD was associated with an increased risk of prevalent (OR = 1.81, 95% CI: 1.23-2.66) and incident (HR = 1.37, 95% CI: 1.10-1.72) CVD. For some specific CVDs, NAFLD was associated with an increased risk of prevalent (OR = 1.87, 95% CI: 1.47-2.37) and incident (HR = 2.31, 95% CI: 1.46-3.65) coronary artery disease (CAD), prevalent (OR = 1.24, 95% CI: 1.14-1.36) and incident (HR = 1.16, 95% CI: 1.06-1.27) hypertension, and prevalent (OR = 1.32, 95% CI: 1.07-1.62) atherosclerosis. In conclusion, the presence of NAFLD is associated with an increased risk of major adverse cardiovascular events, although it is not related to mortality from all causes or CVD.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Forest plot of comparison.
NAFLD versus non-NAFLD, outcome: overall mortality (A) and cardiovascular disease mortality (B) based on cohort studies. Studies assessing NAFLD by ultrasound, liver biopsy or liver enzyme were considered separately.
Figure 2
Figure 2. Forest plot of comparison.
NAFLD versus non-NAFLD, outcome: prevalent cardiovascular disease in cross-sectional studies (A) and incident cardiovascular disease in cohort studies (B). Studies assessing NAFLD by ultrasound or liver biopsywere considered separately.
Figure 3
Figure 3. Forest plot of comparison.
NAFLD versus non-NAFLD, outcome: prevalent coronary artery disease in cross-sectional studies (A) and incident coronary artery disease in cohort studies (B). Studies assessing NAFLD by ultrasound or CT images were considered separately.
Figure 4
Figure 4. Forest plot of comparison.
NAFLD versus non-NAFLD, outcome: prevalent hypertension in cross-sectional studies (A) and incident hypertension in cohort studies (B). Studies assessing NAFLD by ultrasound or CT images were considered separately.
Figure 5
Figure 5. Forest plot of comparison.
NAFLD versus non-NAFLD, outcome: prevalent atherosclerosis based on cross-sectional studies. Studies assessing NAFLD by ultrasound or CT images were considered separately.
Figure 6
Figure 6. Forest plot of comparison.
NASH versus non-NASH, outcome: overall mortality (A), cardiovascular disease mortality (B) and incident cardiovascular disease (C) based on cohort studies. Studies assessing NASH by ultrasound or liver biopsy were considered separately.
See this image and copyright information in PMC

References

    1. Lazo M. & Clark J. M. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis. 28, 339–350 (2008). - PubMed
    1. Ong J. P. & Younossi Z. M. Epidemiology and natural history of NAFLD and NASH. Clin Liver Dis. 11, 1–16, vii (2007). - PubMed
    1. Marchesini G. et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 37, 917–923 (2003). - PubMed
    1. Harrison S. A., Torgerson S. & Hayashi P. H. The natural history of nonalcoholic fatty liver disease: a clinical histopathological study. Am J Gastroenterol. 98, 2042–2047 (2003). - PubMed
    1. Kotronen A. & Yki-Jarvinen H. Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vasc Biol. 28, 27–38 (2008). - PubMed