Bcakgrounds: Non alcoholic fatty liver disease (NAFLD) has been linked independently to cardiovascular disease (CVD) but It is largely unknown if such a relationship between NAFLD and CVD risk relates to severity of liver disease or if it is independent of other potential confounding factors
Methods: This study included 30,172 subjects. Based on the presence or absence of steatosis on ultrasound and serum alanine aminotransferase (ALT), subjects were divided into controls, an increased serum ALT group without steatosis and a group with presumed nonalcoholic fatty liver disease (NAFLD), which included a steatosis alone group and a group with presumed non alcoholic steatohepatitis (NASH) with steatosis and an elevated ALT.
Results: The odds ratio for 10-year risk by total Framingham risk scores ≥10% was 5.3 times higher in NASH groups. The prevalence of diabetes, hypertension, elevated CRP and metabolic syndrome were all increased up to 15 fold over controls, independent of age, BMI, smoking and exercise habits. Overall CVD risk was significantly greater in NASH than in either steatosis or raised ALT alone.
Conclusion: Young, non-obese subjects with NAFLD are at significantly increased CVD risk, especially those with NASH. As well as specific therapy for liver disease, a diagnosis of NAFLD should lead to targeted risk assessment and risk factor modification.
Table 1.
Prevalence of Cardiovascular Risk Factors and 10- year risk
Table 2
Odds Ratios and 95% confidence intervals for Cardiovascular Risk Factors and 10- year risk
Effective Treatment of Nonalcoholic Fatty Liver Disease Using a Community-Based Weight Management Program