Background:
Whether nonalcoholic fatty liver disease (NAFLD) is related to subclinical artherosclerosis is unclear. Coronary artery calcium scanning (CAC) is the robust predictor of coronary events in the asymptomatic individuals. Several recent studies have investigated the association between NAFLD and this surrogate marker. Thus, we conducted a systematic review and meta-analysis to better characterize the association between NAFLD and CAC.
Methods:
A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through May 2016. The inclusion criterion was the observational studies’ assessment of the association between NAFLD and CAC in adult subjects. Pooled odds ratio (OR) and 95% confidence interval (CI) from multivariate model with confounders adjustment were calculated using a random-effect, generic inverse variance method. The between-study heterogeneity of effect-size was quantified using the
Q
statistic and
I
2
.
Results:
Data were extracted from 15 studies (all cross-sectional studies) involving 35,409 subjects. NAFLD is significantly associated with CAC > 0 and CAC > 100 with pooled OR of 1.41 (95% CI 1.24-1.61, P
heterogeneity
= 0.01,
I
2
=57%) (Figure 1) and 1.24 (95% CI 1.02-1.52, P
heterogeneity
= 0.09,
I
2
=42%). The association between NAFLD and CAC > 0 was stronger in women than men (P
between sex
= 0.017).
Conclusions:
NAFLD is also associated with coronary calcification independent of traditional risk factors, obesity and metabolic syndrome in asymptomatic individuals and this association was appeared to be stronger in women.
ASSOCIATIONS BETWEEN NONALCOHOLIC FATTY LIVER DISEASE AND SUBCLINICAL ATHEROSCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
