Analysis On Clinical Association Between Nonalcoholic-fatty Liver Disease And Coronary Artery Atherosclerosis

Background: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronicliver disease, which is characterized by excessive accumulation of fat in the liver cells.NAFLD is strongly correlated with cardiovascular disease (CVD) risk factors, such ashypertension, type2diabetes mellitus, dyslipidemia, obesity, and insulin resistance.CVD patients with NAFLD have a higher mortality than those without. From previouspublished data, it is shown that coronary heart disease (CHD) mortality in patientswith NAFLD are close to or even higher than cirrhosis. However, it is not clearwhether NAFLD is a risk factor of CHD or a feature of metabolic syndrome.Objective: The purpose of this study is to investigate the association betweenNAFLD and CHD, and to investigate whether NAFLD independently correlates withcoronary atherosclerosis.Methods: This retrospective study consists of361patients (190men,171women;aged43-81years) that satisfied inclusion/exclusion criteria and underwent coronaryangiography. NAFLD was detected by using abdominal ultrasonograhy. There were210cases with NALFD (NAFLD group) and118cases without NAFLD(non-NAFLD group, control). The clinical characteristics and the Gensini score ofeach patient were recorded. Statistical evaluations were performed using Student’s ttest, Chi-square, and logistic analysis.Results: Patients with NAFLD showed significantly higher rates of hypertension(59.0%vs.45.0%，P=0.008), type2diabetes mellitus (59.0%vs.45.0%， P=0.008),and metabolic syndrome (22.9%vs.8.6%， P<0.001) compared with those innon-NAFLD group. The difference of proportion was statistically significant ofpatients with atherosclerosis in two groups (89.5%vs.78.8%, P=0.005). NAFLD,elevated ALT and high level ALT, even within the nomal rang were correlated with theeverity of coronary atherosclerosis respectly. Multivariate analysis revealed that thepresence of NAFLD was not associated with CHD and Gensini score independently. The presence of type2diabetes mellitus (OR=6.583, P<0.001), aging (OR=2.401,P=0.002) and cigarette (OR=2.626, P=0.005) was associated with CHD, and thepresence of type2diabetes mellitus (OR=5.254, P<0.001), aging (OR=2.727,P=0.043) and cigarette (OR=2.977, P=0.001)、the decrease of HDL-c (OR=4.425,P=0.010) has an independent effect on the severity of coronary atherosclerosis. ALT(＞25U/L) has an independent effect on the severity of coronary atherosclerosis andCHD, but it doesn’t exit when the threshold was50U/L or40U/L.Conclusions: NAFLD was strongly associated with metabolic syndrome. Ageing,type2diabetes mellitus, cigarette and ALT (＞25U/L) were associated with CHDand the severity of coronary atherosclerosis. NAFLD is weakly associated withatherosclerosis, and NAFLD was not associated with CHD and the severity ofcoronary atherosclerosis confirmed directly by coronary arteriography.