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Nonalcoholic Fatty Liver Disease for Identification of Preclinical Carotid Atherosclerosis

View Article: PubMed Central - PubMed

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease, yet whether identification of NAFLD in asymptomatic individuals is helpful over established risk factors remains unknown. A total of 37,799 asymptomatic adults aged 20 years or older who underwent comprehensive health check-up examination, including abdominal and carotid artery duplex ultrasonography (US) were included in the analysis. Nonalcoholic fatty liver disease was diagnosed with US and exclusion of secondary causes of fat accumulation or other causes of chronic liver disease, and graded as mild or moderate to severe fatty liver. Individuals with carotid plaque identified on carotid artery US were considered at risk for cardiovascular disease. Metabolic syndrome (MetS) was defined by the adult treatment panel III criteria. Nonalcoholic fatty liver disease was an independent factor associated with carotid plaque in a dose-dependent manner (odds ratio [OR]; 95% confidence interval [CI]: 1.09 [1.03–1.16] and 1.13 [1.06–1.21] for mild and ≥ moderate degree of NAFLD). Among clinically-relevant subgroups, NAFLD was more closely associated with carotid plaque in young adults (aged < 60 years) without MetS (OR [95% CI]: 1.13 [1.03–1.19] and 1.16 [1.06–1.27] for mild and ≥ moderate degree of NAFLD) than old adults (aged ≥ 60 years) or with MetS (OR [95% CI]: 1.06 [0.97–1.17] and 1.07 [0.97–1.19] for mild and ≥ moderate degree NAFLD). In young adults without MetS, the prevalence of carotid plaques was 32.8% and the sensitivity and specificity of NAFLD for carotid plaque was 0.38 and 0.67, respectively. In conclusion, NAFLD is associated with carotid plaque independent of traditional risk factors, especially in young adults without MetS. Nonalcoholic fatty liver disease could help identify additional individuals with preclinical atherosclerosis in asymptomatic young adults without MetS, yet, showed suboptimal performance as a screening tool.

No MeSH data available.


Flow diagram of the study participants.
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Figure 1: Flow diagram of the study participants.

Mentions: We screened a total of 70,036 participants aged 20 or older who underwent a routine health check-up examination that includes abdominal ultrasonography (US) and carotid artery duplex US at the Center for Health Promotion of Samsung Medical Center in Seoul, Korea, from January 2005 to December 2013. Among them, we first excluded 11,003 participants with incomplete anthropometric measurements, health questionnaire, or missing laboratory data on lipid profile. Then we further excluded a total of 21,234 individuals who met any of following exclusion criteria: those with history of malignancy (n = 1520), history of CVD (n = 2948), individuals taking aspirin or other antiplatelet drugs (n = 6482), individuals with excessive alcohol consumption (>30 g/d for men and >20 g/d for women) (n = 12,435) and history of cirrhosis, hepatitis B surface antigen or anti-hepatitis C virus positive (n = 3331), to define adults free from cardiovascular disease or other chronic liver disease (Figure 1). The final study population included 37,799 asymptomatic individuals without CVD or chronic liver disease. The study protocol was approved by the institutional review board of Samsung Medical Center. The requirement for informed consent was exempted by the institutional review board because the study was based on retrospective analysis of existing administrative and clinical data.


Nonalcoholic Fatty Liver Disease for Identification of Preclinical Carotid Atherosclerosis
Flow diagram of the study participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998289&req=5

Figure 1: Flow diagram of the study participants.
Mentions: We screened a total of 70,036 participants aged 20 or older who underwent a routine health check-up examination that includes abdominal ultrasonography (US) and carotid artery duplex US at the Center for Health Promotion of Samsung Medical Center in Seoul, Korea, from January 2005 to December 2013. Among them, we first excluded 11,003 participants with incomplete anthropometric measurements, health questionnaire, or missing laboratory data on lipid profile. Then we further excluded a total of 21,234 individuals who met any of following exclusion criteria: those with history of malignancy (n = 1520), history of CVD (n = 2948), individuals taking aspirin or other antiplatelet drugs (n = 6482), individuals with excessive alcohol consumption (>30 g/d for men and >20 g/d for women) (n = 12,435) and history of cirrhosis, hepatitis B surface antigen or anti-hepatitis C virus positive (n = 3331), to define adults free from cardiovascular disease or other chronic liver disease (Figure 1). The final study population included 37,799 asymptomatic individuals without CVD or chronic liver disease. The study protocol was approved by the institutional review board of Samsung Medical Center. The requirement for informed consent was exempted by the institutional review board because the study was based on retrospective analysis of existing administrative and clinical data.

View Article: PubMed Central - PubMed

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease, yet whether identification of NAFLD in asymptomatic individuals is helpful over established risk factors remains unknown. A total of 37,799 asymptomatic adults aged 20 years or older who underwent comprehensive health check-up examination, including abdominal and carotid artery duplex ultrasonography (US) were included in the analysis. Nonalcoholic fatty liver disease was diagnosed with US and exclusion of secondary causes of fat accumulation or other causes of chronic liver disease, and graded as mild or moderate to severe fatty liver. Individuals with carotid plaque identified on carotid artery US were considered at risk for cardiovascular disease. Metabolic syndrome (MetS) was defined by the adult treatment panel III criteria. Nonalcoholic fatty liver disease was an independent factor associated with carotid plaque in a dose-dependent manner (odds ratio [OR]; 95% confidence interval [CI]: 1.09 [1.03–1.16] and 1.13 [1.06–1.21] for mild and ≥ moderate degree of NAFLD). Among clinically-relevant subgroups, NAFLD was more closely associated with carotid plaque in young adults (aged < 60 years) without MetS (OR [95% CI]: 1.13 [1.03–1.19] and 1.16 [1.06–1.27] for mild and ≥ moderate degree of NAFLD) than old adults (aged ≥ 60 years) or with MetS (OR [95% CI]: 1.06 [0.97–1.17] and 1.07 [0.97–1.19] for mild and ≥ moderate degree NAFLD). In young adults without MetS, the prevalence of carotid plaques was 32.8% and the sensitivity and specificity of NAFLD for carotid plaque was 0.38 and 0.67, respectively. In conclusion, NAFLD is associated with carotid plaque independent of traditional risk factors, especially in young adults without MetS. Nonalcoholic fatty liver disease could help identify additional individuals with preclinical atherosclerosis in asymptomatic young adults without MetS, yet, showed suboptimal performance as a screening tool.

No MeSH data available.