Nonalcoholic Fatty Liver Disease as a Risk Factor for Cardiovascular Disease: Using the Estimation of Framingham Risk Score and Carotid Artherosclerosis

Keum, Shin Ho; Lee, Keun Mi; Jung, Seung Pil

Abstract

BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is known to be associated with obesity, type 2 diabetes, and dyslipidemia and highly related to metabolic syndrome. The purpose of this study was to examine NAFLD as a risk factor for cardiovascular disease using the Framingham risk score and carotid intima media thickness.
METHODS
We examined 189 Korean adults older than 20 years who participated in a health screening test and had both carotid and abdominal ultrasounds. Patients with viral hepatitis and history of cardiovascular disease and alcohol consumption (>20 g/day) were excluded. We compared clinical characteristics, the Framingham risk scores, and carotid intima media thickness according to the presence of nonalcoholic fatty liver disease.
RESULTS
Framingham risk scores and the estimated 10-year risk for coronary heart disease were higher in subjects with NAFLD (11.5+/-4.7 vs 10.2+/-4.3 P=0.04, 8.7+/-7.3% vs 4.9+/-5.0% P<0.001). Carotid intima media thickness was higher in subjects with NAFLD (0.72+/-0.18 mm) compared to the controls (0.63+/-0.15 mm) (P<0.001). This result persisted significantly after adjusting for age, sex, and the 5 components of metabolic syndrome. Multiple logistic regression analysis showed that the presence of NAFLD (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.495-5.812) and triglyceride level (OR, 2.06; 95% CI, 1.041-4.066) were independently related with carotid atherosclerosis.
CONCLUSIONS
These results suggest that NAFLD is a risk factor for cardiovascular disease. Physicians should be mindful of this association when seeing patients with NAFLD.