Impact of NAFLD on the Incidence of Cardiovascular Diseases in a Primary Care Population in Germany

Labenz, Christian; Huber, Yvonne; Michel, Maurice Stephan; Nagel, Michael; Galle, Peter R.; Kostev, Karel; Schattenberg, Jörn M.

doi:10.1007/s10620-019-05986-9

Cited by 74 publications

(100 citation statements)

References 33 publications

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“…Our current study adds to the existing literature and highlights that in a heterogeneous, elderly groups of patients carrying an ICD-10 code with NAFLD in Germany, the incidence of dementia was not increased. A recent study in the same database observed that ICD-10 codes of NAFLD are not associated with stroke, which Table 2 Association between NAFLD/NASH and the incidence of all-cause dementia, vascular dementia, and antidementive therapy in patients followed in general practices in Germany (Cox regression models) a Differences in the sample characteristics between those with and those without NAFLD/NASH were tested using chi-squared tests for categorical variables is closely linked to vascular dementia [10]. On the other hand, others have shown an association with white matter injury [20] and altered liver enzymes have recently been associated with early Alzheimer's disease markers [21].…”

Section: Discussionmentioning

confidence: 99%

“…The independent aspect of metabolic liver disease that can be present alongside other liver diseases-including social alcohol use-is currently at the center of an ongoing academic debate [9]. From a pathophysiological point of view, the most obvious independent contribution of NAFLD is with regards to cardiovascular diseases [10][11][12]. Those findings are in parts explained by an increase in systemic inflammation caused by inflammatory processes in the liver.…”

Section: Introductionmentioning

confidence: 99%

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Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

Labenz

Kostev²,

Kaps

et al. 2020

Dig Dis Sci

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Dementia and NAFLD are two frequent conditions that share underlying risk factors mainly in the realm of metabolic disease. Additionally, an association between NAFLD and brain aging has been proposed. Therefore, we investigated the hypothesis if NAFLD is an independent risk factor for emerging dementia. In this population-based cohort study, elderly patients (≥ 65 years) with NAFLD diagnosed between 2000 and 2015 were matched 1:1 to a cohort without NAFLD based on ICD-10 coding in the Disease Analyzer database. Matching criteria were age, sex, physician, index year, and co-diagnoses associated with dementia. The primary outcomes of this study were all-cause dementia diagnoses, the incidence of vascular dementia, and antidementive drug prescription. A total of 22,317 patients with NAFLD were matched to 22,317 patients without NAFLD. Within 10 years of the index date, 16.0% of patients with NAFLD and 15.6% of the patients without NAFLD were diagnosed with dementia. On Cox regression analysis, there is no association between NAFLD and the incidence of all-cause dementia (HR 0.97, 95% CI 0.92-1.04), vascular dementia (HR 0.89, 95% CI 0.78-1.02), or the new prescription of antidementive therapy (HR 0.87, 95% CI 0.76-1.01). In sensitivity analyses, there was no association between NAFLD and dementia in different age-groups as well as men or women. In conclusion, in this database study of elderly patients coded with NAFLD no independent association with incident dementia was detected. Risk assessment regarding dementia in patients with NAFLD should be carried out in the same way as for metabolic burdened patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

Labenz

Kostev²,

Kaps

et al. 2020

Dig Dis Sci

Self Cite

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“…Other large studies recently showed that NAFLD was independently associated with an increased incidence of acute myocardial infarction, even in primary care populations [21,22]. However, this latter finding has recently been questioned in a population-based case-control study that failed to find any significant association between a recorded diagnosis of NAFLD and risk of developing myocardial infarction and stroke, after adjustment for traditional CVD risk factors, using electronic records from four large European primary healthcare databases [23].…”

Section: Risk Of Cvd and Other Cardiac Complicationsmentioning

confidence: 99%

NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications

Targher

Byrne

Tilg

2020

Gut

481

365

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Non-alcoholic fatty liver disease (NAFLD) is a public health problem, affecting up to a third of the world’s adult population. Several cohort studies have consistently documented that NAFLD (especially in its more advanced forms) is associated with a higher risk of all-cause mortality and that the leading causes of death among patients with NAFLD are cardiovascular diseases (CVDs), followed by extrahepatic malignancies and liver-related complications. A growing body of evidence also indicates that NAFLD is strongly associated with an increased risk of major CVD events and other cardiac complications (ie, cardiomyopathy, cardiac valvular calcification and cardiac arrhythmias), independently of traditional cardiovascular risk factors. This narrative review provides an overview of the literature on: (1) the evidence for an association between NAFLD and increased risk of cardiovascular, cardiac and arrhythmic complications, (2) the putative pathophysiological mechanisms linking NAFLD to CVD and other cardiac complications and (3) the current pharmacological treatments for NAFLD that might also benefit or adversely affect risk of CVD.

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“…In the current issue of Digestive Diseases and Sciences, Labenz et al identified an association between NAFLD and CVD in a large administrative database of primary care practices in Germany [5]. In this study, CVD was defined as incident myocardial infarction (MI), coronary heart disease (CHD), atrial fibrillation (AF), and stroke.…”

Section: Introductionmentioning

confidence: 96%

The Emerging Epidemic of Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: True, True, and Related?

2020

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Impact of NAFLD on the Incidence of Cardiovascular Diseases in a Primary Care Population in Germany

Cited by 74 publications

References 33 publications

Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications

The Emerging Epidemic of Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: True, True, and Related?

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