Association between nonalcoholic fatty liver disease and subclinical atherosclerosis: a cross-sectional study on population over 40 years old

Abstract

BackgroundNonalcoholic fatty liver disease (NAFLD) refers to fatty infiltration of liver in the absence of excessive alcohol abuse. However, the problem that whether NAFLD is correlated with subclinical atherosclerosis assessed by carotid intima-media thickness (CIMT) and brachial-ankle pulse wave velocity (ba-PWV) remains a source of controversy. This can be attributed to the differences in diagnosis methods, population ethnicity, sampling size and bias. This study aimed to further investigate the association of NAFLD with subclinical atherosclerosis.MethodsA cross-sectional study was carried out in the current study on population aged over 40 years derived from Kailuan community-based prospective study among Chinese adults from June 2010 to June 2011. NAFLD was evaluated through ultrasonography and histories of alcohol consumption. Clinical parameters and medical histories of patients were collected in the manner of interview performed by trained investigators using the standardized questionnaires. The biochemical parameters were analyzed at the central laboratory. CIMT and ba-PWV of each patient were measured. Multivariate logistic regression was used to analyze the associations of NAFLD with subclinical atherosclerosis assessed by CIMT or ba-PWV.ResultsA total of 4112 participants aged over 40 years were enrolled from Kailuan cohort, including 2229 men and 1883 women. The overall prevalence of NAFLD was 38.2% in the total population. Statistically significant differences were found in CIMT (P < 0.0001) and ba-PWV (P = 0.0007) according to the presence of NAFLD. It is notably that the multivariate logistic regression revealed NAFLD was independently associated with elevated CIMT after adjusting the conventional cardiovascular and metabolic risk factors (OR = 1.663, 95% CI = 1.391–1.989, P < 0.0001). In addition, NAFLD was also found to be positively associated with elevated ba-PWV after adjusting age, gender, BMI, current smoking and regular exercising (OR = 1.319, 95% CI = 1.072–1.624, P = 0.0089).ConclusionsOur findings suggest that NAFLD is remarkably correlated with subclinical atherosclerosis, which should be strongly advised to engage in the preventive strategies for cardiovascular diseases (CVDs).

Dysregulated lipid metabolism links NAFLD to cardiovascular disease

“…Interestingly, the annual rate of CAC progression was significantly higher in participants with ultrasound defined-NAFLD compared to those without NAFLD at baseline and was further increased in subjects with elevated NFS independent of obesity, hypertension, dyslipidemia, and diabetes [ 19 ]. CIMT is also increased in patients with NAFLD (diagnosed by ultrasound or CT) independent of dyslipidemia and hypertension [ 17 , 20 ]. Interestingly, a prospective study showed that increased CIMT and ba-PWV at baseline were associated with a higher risk of developing NAFLD (assessed by ultrasound) and ba-PWV was associated with a higher likelihood of fibrosis as assessed by the NFS, fibrosis-4 (FIB4), and aspartate transaminase (AST) to platelet ratio index (APRI) scores [ 21 ].…”

“…However, more studies with bona fide histological assessment of NASH and fibrosis are needed to further explore this hypothesis. Interestingly, some studies failed to find an association between ultrasound-defined NAFLD and subclinical atherosclerosis by measuring ba-PWV [ 20 ], carotid to femoral (cf-) PWV [ 22 ], or CAC-defined calcification (higher CAC cutoff >10) [ 23 ] after adjustment for other risk factors.…”

Long non-coding RNA H19 in atherosclerosis: what role?

“…Nonalcoholic fatty liver disease (NAFLD) is strongly associated with atherosclerosis (Sookoian and Pirola 2008 ; Zheng et al 2018 ). Peroxisome proliferator-activated receptor γ (PPARγ) was reported to be correlated with NAFLD (Zhu et al 2019b ).…”

The Liver in Children With Metabolic Syndrome

“…Recently Zheng et al (94) performed a cross-sectional study confirming that NAFLD is positively correlated with atherogenic lipid profile and patients enrolled with NAFLD shown carotid intima-media thickness (CIMT) and elevated brachial-ankle pulse wave velocity (ba-PWV) for stiffening.…”