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Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time.
Clin Cardiol. 2016 Jun; 39(6):321-8.CC

Abstract

BACKGROUND

Nonalcoholic fatty liver disease, insulin resistance (IR), and obesity frequently coexist with type 2 diabetes mellitus (DM), but it is uncertain whether these risk factors for vascular disease contribute to a change in atherosclerosis over time, independently of DM status.

HYPOTHESIS

We hypothesized that the combination of fatty liver, IR, and obesity would be associated with an increase in coronary artery calcium (CAC) score over time, independently of DM status, other cardiovascular risk factors, and medications.

METHODS

Data were analyzed from a South Korean occupational cohort of 2175 people. The outcome was increase in cardiac computed tomography CAC score between baseline and follow-up. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR) ≥75th percentile and fatty liver by ultrasound.

RESULTS

In 592 (27.2%) participants, CAC score increased from baseline (mean ± SD; mean age at baseline, 44.8 ± 5.5 years); and in 1583 subjects, CAC did not change or improved during follow-up (mean age, 41.6 ± 5.6 years). Diabetes mellitus, HOMA-IR, fatty liver, and obesity prevalence were all higher (all P < 0.001) in participants whose CAC score increased from baseline. Adjusting for DM and potential confounders, the combination of IR, obesity, and fatty liver was independently associated with increase in CAC score over time (hazard ratio: 2.46, 95% confidence interval: 1.50-4.03).

CONCLUSIONS

The combination of fatty liver, IR, and obesity is associated with progression of atherosclerosis over time independently of DM, cardiovascular risk factors, and all medications for cardiovascular disease and DM.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.Nutrition and Metabolism Unit, Southampton General Hospital (University of Southampton) and Southampton National Institute for Health Research Biomedical Research Centre, Southampton, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26997000

Citation

Sung, Ki-Chul, et al. "Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time." Clinical Cardiology, vol. 39, no. 6, 2016, pp. 321-8.
Sung KC, Ryu S, Lee JY, et al. Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time. Clin Cardiol. 2016;39(6):321-8.
Sung, K. C., Ryu, S., Lee, J. Y., Lee, S. H., Cheong, E. S., Wild, S. H., & Byrne, C. D. (2016). Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time. Clinical Cardiology, 39(6), 321-8. https://doi.org/10.1002/clc.22529
Sung KC, et al. Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time. Clin Cardiol. 2016;39(6):321-8. PubMed PMID: 26997000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time. AU - Sung,Ki-Chul, AU - Ryu,Seungho, AU - Lee,Jong-Young, AU - Lee,Sung Ho, AU - Cheong,Eun Sun, AU - Wild,Sarah H, AU - Byrne,Christopher D, Y1 - 2016/03/21/ PY - 2015/11/30/received PY - 2016/01/30/revised PY - 2016/3/22/entrez PY - 2016/3/22/pubmed PY - 2017/3/1/medline SP - 321 EP - 8 JF - Clinical cardiology JO - Clin Cardiol VL - 39 IS - 6 N2 - BACKGROUND: Nonalcoholic fatty liver disease, insulin resistance (IR), and obesity frequently coexist with type 2 diabetes mellitus (DM), but it is uncertain whether these risk factors for vascular disease contribute to a change in atherosclerosis over time, independently of DM status. HYPOTHESIS: We hypothesized that the combination of fatty liver, IR, and obesity would be associated with an increase in coronary artery calcium (CAC) score over time, independently of DM status, other cardiovascular risk factors, and medications. METHODS: Data were analyzed from a South Korean occupational cohort of 2175 people. The outcome was increase in cardiac computed tomography CAC score between baseline and follow-up. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR) ≥75th percentile and fatty liver by ultrasound. RESULTS: In 592 (27.2%) participants, CAC score increased from baseline (mean ± SD; mean age at baseline, 44.8 ± 5.5 years); and in 1583 subjects, CAC did not change or improved during follow-up (mean age, 41.6 ± 5.6 years). Diabetes mellitus, HOMA-IR, fatty liver, and obesity prevalence were all higher (all P < 0.001) in participants whose CAC score increased from baseline. Adjusting for DM and potential confounders, the combination of IR, obesity, and fatty liver was independently associated with increase in CAC score over time (hazard ratio: 2.46, 95% confidence interval: 1.50-4.03). CONCLUSIONS: The combination of fatty liver, IR, and obesity is associated with progression of atherosclerosis over time independently of DM, cardiovascular risk factors, and all medications for cardiovascular disease and DM. SN - 1932-8737 UR - https://www.unboundmedicine.com/medline/citation/26997000/Fatty_Liver_Insulin_Resistance_and_Obesity:_Relationships_With_Increase_in_Coronary_Artery_Calcium_Over_Time_ L2 - https://doi.org/10.1002/clc.22529 DB - PRIME DP - Unbound Medicine ER -