Coronary artery disease and non-alcoholic fatty liver disease: Clinical correlation using computed tomography coronary calcium scans

Abstract

Background and aim: Non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) have been explored using coronary angiography, which showed a link between severe NAFLD and cardiovascular disease risk. This study's aim is to determine if computed tomography (CT) coronary artery calcium (CAC) scores used to determine CAD severity in asymptomatic populations can help predict the presence of NAFLD.

Methods: This was a retrospective cross-sectional study of positive CT CAC scores and liver imaging with either CT; ultrasound; magnetic resonance imaging of the abdomen; or CT of the chest, which included liver images. Drinking 7 or 14 drinks per week for a female or male, respectively, and chronic viral hepatitis diagnosis were the exclusion criteria. CT CAC scores, hepatic steatosis, age, gender, lipid and liver panels, weight, blood pressure, F-4/BARD scores, and hemoglobin A1c were correlated to CAD severity and NAFLD by logistic regression.

Results: A total of 134 patients with a mean age of 62.3 years (σ = 9.1), with 65% males, body mass index 28.5 (σ = 6.0), and 8% diabetics, were recruited. CAD severity was not associated with the presence of hepatic steatosis (odds ratio 1.96 [95% confidence interval, confidence interval 0.74-5.23] P = 0.36). Adjusted for variables, a link between hepatic steatosis, CAD severity, body mass index over 30 (odds ratio 6.77 [95% confidence interval 1.40-32.66] P = 0.02), and diabetes (odds ratio 9.60 [95% confidence interval 0.56-165.5] P = 0.01) was observed.

Conclusions: In patients with CAD detected using a positive CT CAC scan, we determined that BMI over 30 and diabetes were correlated with the presence of NAFLD. There was no direct relationship between CAD presence and hepatic steatosis presence.

Keywords: clinical correlation; computed tomography coronary artery calcium score; coronary artery disease; non‐alcoholic fatty liver disease.

Figure 1

Flow of participants through the study. CT CAC, computed tomography coronary artery calcium.

Figure 2

Percentage of patients with abnormal lab values. The number of patients with lab and clinical data outside the normal ranges was used to calculate statistical significance of coronary artery disease (CAD) severity and non‐alcoholic fatty liver disease (NAFLD) presence. *P = 0.03 for NAFLD only, **P = 0.02 for both CAD and NAFLD, †P = 0.01 for both CAD and NAFLD, ‡P = 0.02 for CAD only. ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; HDL, high‐density lipoproteins; LDL, low‐density lipoproteins.