TY - JOUR
T1 - Associations between nonalcoholic fatty liver disease and subclinical atherosclerosis in middle-aged adults
T2 - The coronary artery risk development in young adults study
AU - VanWagner, Lisa B.
AU - Ning, Hongyan
AU - Lewis, Cora E.
AU - Shay, Christina M.
AU - Wilkins, John
AU - Carr, J. Jeffrey
AU - Terry, James G.
AU - Lloyd-Jones, Donald M.
AU - Jacobs, David R.
AU - Carnethon, Mercedes R.
N1 - Funding Information:
2. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham ( HHSN268201300025C & HHSN268201300026C ), Northwestern University ( HHSN268201300027C ), University of Minnesota ( HHSN268201300028C ), Kaiser Foundation Research Institute ( HHSN268201300029C ), and Johns Hopkins University School of Medicine ( HHSN268200900041C ). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging . This manuscript has been reviewed by CARDIA for scientific content.
Funding Information:
3. L.B.V. is supported by the National Institutes of Health ( 1 F32 HL116151-01 ) and the American Liver Foundation (New York, NY).
Funding Information:
4. J.J.C. is supported by the National Institutes of Health ( R01-HL-098445 ), which funded the measures of CAC and AAC for the year 25 exam.
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2014/8/1
Y1 - 2014/8/1
N2 - Objective: Non-alcoholic fatty liver disease (NAFLD) is an obesity-related condition associated with cardiovascular mortality. Yet, whether or not NAFLD is independently related to atherosclerosis is unclear. In a population-based cross-sectional sample of middle-aged adults free from liver or heart disease, we tested the hypothesis that NAFLD is associated with subclinical atherosclerosis (coronary artery (CAC) and abdominal aortic calcification (AAC)) independent of obesity. Methods: Participants from the Coronary Artery Risk Development in Young Adults study with CT quantification of liver fat, CAC and AAC were included (n=2424). NAFLD was defined as liver attenuation ≤40 Hounsfield Units after exclusion of other causes of liver fat. CAC and AAC presence was defined as Agatston score >0. Results: Mean participant age was 50.1±3.6 years, (42.7% men, 50.0% black) and BMI was 30.6±7.2kg/m2. The prevalence of NAFLD, CAC, and AAC was 9.6%, 27.1%, and 51.4%. NAFLD participants had increased prevalence of CAC (37.9% vs. 26.0%, p<0.001) and AAC (65.1% vs. 49.9%, p<0.001). NAFLD remained associated with CAC (OR, 1.33; 95% CI, 1.001-1.82) and AAC (OR, 1.74; 95% CI, 1.29-2.35) after adjustment for demographics and health behaviors. However, these associations were attenuated after additional adjustment for visceral adipose tissue (CAC OR, 1.05; 95% CI, 0.74-1.48, AAC OR=1.20; 95% CI, 0.86-1.67). There was no interaction by race or sex. Conclusion: In contrast to prior research, these findings suggest that obesity attenuates the relationship between NAFLD and subclinical atherosclerosis. Further studies evaluating the role of NAFLD duration on atherosclerotic progression and cardiovascular events are needed.
AB - Objective: Non-alcoholic fatty liver disease (NAFLD) is an obesity-related condition associated with cardiovascular mortality. Yet, whether or not NAFLD is independently related to atherosclerosis is unclear. In a population-based cross-sectional sample of middle-aged adults free from liver or heart disease, we tested the hypothesis that NAFLD is associated with subclinical atherosclerosis (coronary artery (CAC) and abdominal aortic calcification (AAC)) independent of obesity. Methods: Participants from the Coronary Artery Risk Development in Young Adults study with CT quantification of liver fat, CAC and AAC were included (n=2424). NAFLD was defined as liver attenuation ≤40 Hounsfield Units after exclusion of other causes of liver fat. CAC and AAC presence was defined as Agatston score >0. Results: Mean participant age was 50.1±3.6 years, (42.7% men, 50.0% black) and BMI was 30.6±7.2kg/m2. The prevalence of NAFLD, CAC, and AAC was 9.6%, 27.1%, and 51.4%. NAFLD participants had increased prevalence of CAC (37.9% vs. 26.0%, p<0.001) and AAC (65.1% vs. 49.9%, p<0.001). NAFLD remained associated with CAC (OR, 1.33; 95% CI, 1.001-1.82) and AAC (OR, 1.74; 95% CI, 1.29-2.35) after adjustment for demographics and health behaviors. However, these associations were attenuated after additional adjustment for visceral adipose tissue (CAC OR, 1.05; 95% CI, 0.74-1.48, AAC OR=1.20; 95% CI, 0.86-1.67). There was no interaction by race or sex. Conclusion: In contrast to prior research, these findings suggest that obesity attenuates the relationship between NAFLD and subclinical atherosclerosis. Further studies evaluating the role of NAFLD duration on atherosclerotic progression and cardiovascular events are needed.
KW - Calcium
KW - Cardiovascular diseases
KW - Epidemiology
KW - Imaging
KW - Liver
KW - Obesity
KW - Risk factors
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U2 - 10.1016/j.atherosclerosis.2014.05.962
DO - 10.1016/j.atherosclerosis.2014.05.962
M3 - Article
C2 - 24956534
AN - SCOPUS:84907380058
SN - 0021-9150
VL - 235
SP - 599
EP - 605
JO - Atherosclerosis
JF - Atherosclerosis
IS - 2
ER -