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Study identifies strong link between CAD, hepatic steatosis
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Asymptomatic patients with hepatic steatosis may be at significantly increased risk for CAD, as indicated by increased coronary artery calcification.
In a cross-sectional study, researchers evaluated 377 asymptomatic adults who underwent coronary calcium score measurement via noncontrast CT. All participants were enrolled between April 1, 2011, and Sept. 30, 2012, and were free of CAD and liver disease at baseline.
The researchers developed an a priori model including diabetes, metabolic syndrome and Framingham risk factors to predict significant CAD (coronary calcium score ≥100 Agatston units), then added hepatic steatosis to the model to determine its impact on predictive ability.
According to results, significant disease was present in 18% of the cohort (mean coronary calcium score, 18.8). CT results indicated hepatic steatosis in 11.4% of patients and 14.9% had metabolic syndrome.
The presence of hepatic steatosis in addition to traditional CAD risk factors was independently associated with a calcium score of ≥100 (OR=2.85; 95% CI, 1.26-6.44). The association between significant CAD and hepatic steatosis was more pronounced than that observed between significant disease and traditional risk factors including diabetes (OR=1.27; 95% CI, 0.46-3.53) metabolic syndrome (OR=2.09; 95% CI, 0.79-5.52), male sex (OR=2.75; 95% CI, 1.47-5.16), advanced age (OR=2.29; 95% CI, 1.62-3.24) and smoking (OR=1.66,; 95% CI, 0.9-3.06).Similarly, a coronary calcium score of ≥100 was associated with risk for hepatic steatosis (OR=2.45; 95% CI, 1.08-5.54). This association was also stronger than that observed between elevated hepatic steatosis risk and either metabolic syndrome or traditional steatosis risk factors including BMI, advanced age and dyslipidemia.
“If current trends continue, the prevalence of [non-alcoholic fatty liver disease] is expected to increase to 40% of the population by 2020,” John Helzberg, MD, from Saint Luke’s Health System, said in a press release. “This discovery is important in identifying potential cardiovascular disease in [non-alcoholic fatty liver disease] patients. Hopefully future research will yield better treatment options and disease management.”
Disclosure: The research was supported by a grant from Saint Luke’s Foundation and Saint Luke’s Mid America Heart Institute.
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