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Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population.
Clin Gastroenterol Hepatol. 2012 Jun; 10(6):646-50.CG

Abstract

BACKGROUND & AIMS

Nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs) have common metabolic risk factors. Despite reports from clinical studies, the association between NAFLD, cardiovascular disease, and cardiovascular mortality are not clear at the population level.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey III, conducted from 1988 to 1994, and compared hepatic ultrasound and mortality data. Participants were classified into those with NAFLD (moderate or severe hepatic steatosis, based on ultrasound analysis, without any evidence of other liver disease; n = 2492) and those without (absence of NAFLD or any other chronic liver diseases: controls). The prevalence of CVD was compared between subjects with and without NAFLD. Additional comparisons were made between NAFLD patients who had increased levels of liver enzymes and those who had normal levels. Independent predictors of CVD and cardiovascular mortality also were studied.

RESULTS

During the follow-up period (median, 171 mo), 12.21% of the National Health and Nutrition Examination Survey III participants died; cardiovascular mortality was 3.76%. Regardless of whether levels of liver enzymes were increased or not, individuals with NAFLD were older, predominantly male, more likely to be Hispanic, and less likely to be African American than controls. They also had a higher prevalence of all components of metabolic syndrome and CVD. Regardless of levels of liver enzymes, NAFLD was associated independently with CVD, after adjusting for major demographic, clinical, and metabolic confounders (odds ratio, 1.23; 95% confidence interval, 1.04-1.44). The independent association of NAFLD with cardiovascular mortality was not statistically significant.

CONCLUSIONS

NAFLD is associated independently with an increased risk of CVD. However, NAFLD did not increase cardiovascular mortality over a 14-year period.

Authors+Show Affiliations

Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22245962

Citation

Stepanova, Maria, and Zobair M. Younossi. "Independent Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Disease in the US Population." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 10, no. 6, 2012, pp. 646-50.
Stepanova M, Younossi ZM. Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population. Clin Gastroenterol Hepatol. 2012;10(6):646-50.
Stepanova, M., & Younossi, Z. M. (2012). Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 10(6), 646-50. https://doi.org/10.1016/j.cgh.2011.12.039
Stepanova M, Younossi ZM. Independent Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Disease in the US Population. Clin Gastroenterol Hepatol. 2012;10(6):646-50. PubMed PMID: 22245962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population. AU - Stepanova,Maria, AU - Younossi,Zobair M, Y1 - 2012/01/13/ PY - 2011/09/21/received PY - 2011/12/05/revised PY - 2011/12/28/accepted PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2012/9/20/medline SP - 646 EP - 50 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin Gastroenterol Hepatol VL - 10 IS - 6 N2 - BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs) have common metabolic risk factors. Despite reports from clinical studies, the association between NAFLD, cardiovascular disease, and cardiovascular mortality are not clear at the population level. METHODS: We analyzed data from the National Health and Nutrition Examination Survey III, conducted from 1988 to 1994, and compared hepatic ultrasound and mortality data. Participants were classified into those with NAFLD (moderate or severe hepatic steatosis, based on ultrasound analysis, without any evidence of other liver disease; n = 2492) and those without (absence of NAFLD or any other chronic liver diseases: controls). The prevalence of CVD was compared between subjects with and without NAFLD. Additional comparisons were made between NAFLD patients who had increased levels of liver enzymes and those who had normal levels. Independent predictors of CVD and cardiovascular mortality also were studied. RESULTS: During the follow-up period (median, 171 mo), 12.21% of the National Health and Nutrition Examination Survey III participants died; cardiovascular mortality was 3.76%. Regardless of whether levels of liver enzymes were increased or not, individuals with NAFLD were older, predominantly male, more likely to be Hispanic, and less likely to be African American than controls. They also had a higher prevalence of all components of metabolic syndrome and CVD. Regardless of levels of liver enzymes, NAFLD was associated independently with CVD, after adjusting for major demographic, clinical, and metabolic confounders (odds ratio, 1.23; 95% confidence interval, 1.04-1.44). The independent association of NAFLD with cardiovascular mortality was not statistically significant. CONCLUSIONS: NAFLD is associated independently with an increased risk of CVD. However, NAFLD did not increase cardiovascular mortality over a 14-year period. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/22245962/Independent_association_between_nonalcoholic_fatty_liver_disease_and_cardiovascular_disease_in_the_US_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(12)00055-9 DB - PRIME DP - Unbound Medicine ER -