Liver fat percentage does not alter risk for CV events
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SAN DIEGO — Liver fat content is not associated with risk for any cardiovascular event, according to data from the Dallas Heart Study presented at the AACE Annual Scientific and Clinical Conference.
“Because of the high prevalence of CV events in patients with nonalcoholic fatty liver disease (NAFLD), we expected to see an association between liver fat and CV events,” Minh-da Le, MD, an endocrinology fellow at University of Texas Southwestern, told Healio. “We were surprised to find no association between CVD and degree of steatosis, yet this would not be the first study that noted this finding.”
Le and colleagues conducted a post-evaluation of prospective data from participants in the Dallas Heart Study, a population-based multiethnic cohort study conducted in Dallas. Adults aged 18 to 65 years with valid liver fat measurements and no CVD at baseline were included in the study. The first phase of the study was conducted between 2000 and 2002. Liver fat percentage was assessed by magnetic resonance spectroscopy. The cohort was divided into tertiles based on liver fat percentage. Composite first CVD event was the primary outcome, including CV death, nonfatal myocardial infarction, nonfatal stroke, coronary or peripheral artery revascularization, hospitalization for heart failure and hospitalization for atrial fibrillation. Secondary outcomes included coronary heart disease, all atherosclerosis and non-atherosclerosis events, and all-cause mortality. Event collection was adjudicated through Dec. 31, 2015.
There were 1,932 adults included in the analysis (mean age, 43 years; 48.1% men), of whom 9.3% had an initial CVD event during the follow-up period. In multivariable analysis, adults in the highest and the middle liver fat tertiles did not have an increased risk for CV events compared with those in the lowest tertile. There was also no difference in risk for CHD, atherosclerosis events, non-atherosclerosis events and all-cause mortality between the tertiles.
Researchers collected the time to first CV event in each tertile and validated it using restricted mean survival times. No consistent patterns were observed for any outcomes in the time to first event, and the restricted mean survival times were similar among the three liver fat tertile groups.
Le said more research should be conducted to confirm the findings in other cohorts and also to examine whether more advanced disease, such as nonalcoholic steatohepatitis or cirrhosis, affects CV risk.
“At this time, to reduce CV risk, we should treat comorbidities such as obesity, hyperlipidemia and diabetes,” Le said. “Treatment of these comorbidities will also address NAFLD, and this treatment approach is currently the only validated treatment for NAFLD.”
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Le M, et al. Liver fat and cardiovascular events: Bystander or causative relationship? Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; May 12-14, 2022; San Diego.
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