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
. 2017 Feb;66(2):390-397.
doi: 10.1016/j.jhep.2016.09.022. Epub 2016 Oct 10.

Bi-directional analysis between fatty liver and cardiovascular disease risk factors

Jiantao Ma  1 , Shih-Jen Hwang  1 , Alison Pedley  1 , Joseph M Massaro  2 , Udo Hoffmann  3 , Raymond T Chung  4 , Emelia J Benjamin  5 , Daniel Levy  1 , Caroline S Fox  6 , Michelle T Long  7
Affiliations

Bi-directional analysis between fatty liver and cardiovascular disease risk factors

Jiantao Ma et al. J Hepatol. 2017 Feb.

Abstract

Background & aims: The relations of non-alcoholic fatty liver disease to cardiovascular disease (CVD) risk factors are not fully understood. The objective of our study is to explore the bi-directional relationships of fatty liver to CVD risk factors.

Methods: We prospectively evaluated whether liver fat predicted the development of CVD risk factors and whether CVD risk factors predicted new onset fatty liver during 6years of follow-up in middle- to older-aged Framingham Heart Study participants. We estimated liver fat using multi-detector computed tomography.

Results: We included 1051 participants (mean age 45±6years, 46% women). The prevalence of fatty liver was 18% at baseline. In participants without fatty liver at baseline, 101 participants developed incident fatty liver over approximately 6years. Baseline liver fat (per standard deviation increase) was associated with increased odds of incident hypertension (OR 1.42; 95% CI 1.15-1.76; p=0.001) and incident type 2 diabetes (OR 1.43; 95% CI 1.09-1.88, p<0.001). In a parallel analysis, individuals with hypertension (OR 3.34; 95% CI 2.04-5.49), hypertriglyceridemia (OR 3.04; 95% CI: 1.84-5.02), impaired fasting glucose (OR 2.92; 95% CI 1.76-4.82), or type 2 diabetes (OR 4.15; 95% CI 1.19-14.46) at baseline had higher odds of incident fatty liver compared to individuals without those conditions (all p<0.03). In both analyses, the observed associations remained similar after additional adjustments for measures of adiposity.

Conclusions: The present study demonstrated bi-directional relationships between fatty liver and CVD risk factors among middle- to older-aged Framingham Heart Study participants.

Lay summary: It is not fully understood whether non-alcoholic fatty liver (NAFLD) disease precedes or develops after increased cardiovascular disease (CVD) risk factors. The findings of our study suggest a bi-directional relationship between NAFLD and CVD risk factors.

Keywords: Cardiovascular disease risk factors; Hypertension; Hypertriglyceridemia; Impaired fasting glucose; Metabolic syndrome; Non-alcoholic fatty liver; Type 2 diabetes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study sample in analyses of bidirectional relationship between fatty liver and cardiovascular disease risk factors. MDCT: multi-detector computed tomography; VAT: visceral adipose tissue.
See this image and copyright information in PMC

References

    1. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55:2005–2023. - PubMed
    1. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Alimentary pharmacology & therapeutics. 2011;34:274–285. - PubMed
    1. Cohen JC, Horton JD, Hobbs HH. Human fatty liver disease: old questions and new insights. Science. 2011;332:1519–1523. - PMC - PubMed
    1. McCullough AJ. The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease. Clinics in liver disease. 2004;8:521–533, viii. - PubMed
    1. Feitosa MF, Reiner AP, Wojczynski MK, Graff M, North KE, Carr JJ, et al. Sex-influenced association of nonalcoholic fatty liver disease with coronary heart disease. Atherosclerosis. 2013;227:420–424. - PMC - PubMed

Publication types

LinkOut - more resources