scholarly journals Nonalcoholic Fatty Liver Disease in Non-Obese Subjects With Abdominal Obesity is Associated With A Higher Risk of Advanced Cardiovascular Disease: A 14 Year Prospective Cohort Study

2020 ◽  
Author(s):  
Mi Kyoung Son ◽  
Ji Hye Park ◽  
Joung-won Lee ◽  
Seungwoo Kim ◽  
Won Ho Kim
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Abdominal Obesity ◽  
Fatty Liver Disease ◽  
Full Cohort ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Obese Subjects

Abstract Background Obese nonalcoholic fatty liver disease (NAFLD) is closely associated with an increased risk of cardiovascular disease (CVD). However, the association between non-obese NAFLD and the incidence of CVD is still unclear and little is known about deleterious factors related to their inter-relationship. Here, we investigated the effects of abdominal obesity (AO) and/or NAFLD on CVD risk.Methods We enrolled 8,422 patients who did not have CVD or consume excessive amounts of alcohol at baseline from the Korean Genome and Epidemiology Study (KoGES). NAFLD was defined using the Fatty Liver Index (FLI). Obesity was defined as a body mass index (BMI) ≥25 kg/m2, and AO was defined as a waist circumference (WC) ≥90 cm in men and ≥85 cm in women. Subjects were sub-divided into eight groups depending on whether they were obese, AO, and/or NAFLD.Results In the full cohort, during a median 11.6 years of follow-up period, the incidence rate (IR) of CVD was 8.07%. The IR of CVD in participants with NAFLD was 1.9-fold higher than in those without NAFLD. The IR per 1,000 person-years for CVD was highest in the non-obese abdominal obesity subjects with NAFLD (15.76 [95% confidence interval (CI), 11.76–20.69]). Compared with participants who did not have obesity, AO, or NAFLD, the adjusted hazard ratio for CVD was 1.67 (95% CI: 1.16–2.41) in non-obese NAFLD patients with AO, 1.60 (95% CI: 1.21–2.11) in NAFLD patients with obesity and AO, and 0.54 (95% CI: 0.32–0.91) in obese subjects without either NAFLD or AO.Conclusions The co-occurrence of AO with NAFLD appears to be strongly associated with an increased risk of CVD regardless of obesity; but its risk is higher in non-obese subjects. By contrast, obese individuals without AO or NAFLD appear to be at lower risk. Therefore, early prevention and control of AO and NAFLD is an important means of reducing the risk of CVD, even in subjects with a normal BMI.

Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: Overlapping Mechanisms

2021 ◽  
Author(s):  
Søren Møller ◽  
Nina Kimer ◽  
Thit Kronborg ◽  
Josephine Grandt ◽  
Jens Dahlgaard Hove ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Severe Form ◽  
Nonalcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Near Future

AbstractNonalcoholic fatty liver disease (NAFLD) denotes a condition with excess fat in the liver. The prevalence of NAFLD is increasing, averaging > 25% of the Western population. In 25% of the patients, NAFLD progresses to its more severe form: nonalcoholic steatohepatitis and >25% of these progress to cirrhosis following activation of inflammatory and fibrotic processes. NAFLD is associated with obesity, type 2 diabetes, and the metabolic syndrome and represents a considerable and increasing health burden. In the near future, NAFLD cirrhosis is expected to be the most common cause for liver transplantation. NAFLD patients have an increased risk of developing cardiovascular disease as well as liver-related morbidity. In addition, hepatic steatosis itself appears to represent an independent cardiovascular risk factor. In the present review, we provide an overview of the overlapping mechanisms and prevalence of NAFLD and cardiovascular disease.

scholarly journals Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
So-Ryoung Lee ◽  
Kyung-Do Han ◽  
Eue-Keun Choi ◽  
Seil Oh ◽  
Gregory Y. H. Lip
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Body Mass ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

scholarly journals Lean Nonalcoholic Fatty Liver Disease and Risk of Incident Diabetes in a Euglycemic Population Receiving Health Checkups: A Cohort Study

2020 ◽  
Author(s):  
Limin Wei ◽  
Xin Cheng ◽  
Yulong Luo ◽  
Rongxuan Yang ◽  
Zitong Lei ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Incident Diabetes ◽  
Benign Condition ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Lean Nafld

Abstract Background: Although recent evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance and an increased risk of diabetes, the association between lean NAFLD and incident diabetes is unclear. This study aimed to investigate whether lean NAFLD and overweight/obese NAFLD have similar or dissimilar effects on the risk of new-onset diabetes.Methods: A longitudinal study was performed in 14,482 euglycemic adults who participated in a health check-up program. Fatty liver was diagnosed by abdominal ultrasonography. The outcome of interest was incident diabetes.Cox proportional hazards regression models were applied to calculate HRs with 95% CIs for future diabetes risk.Results: During the median 6.0 years of follow-up, 356 cases of diabetes occurred. Despite a low probability of hepatic fibrosis indicated by the BAAT score, lean NAFLD was positively associated with an increased risk of diabetes. Moreover, after adjusting for sociodemographic and potential confounders, the fullyadjusted HRs (95% CIs) for incident diabetes between lean NAFLD and overweight/obese NAFLD to the reference (lean without NAFLD) were 2.58 (95% CI 1.68 to 3.97) and 2.52 (95% CI 1.79 to 3.55), respectively. In post hoc analysis, the HR (95% CI) for diabetes comparing lean NAFLD to obese/overweight NAFLD was 1.02 (95% CI 0.68 to 1.54, p = 0.909). The results were robust to challenges in multiple subgroup analyses and appeared to be more pronounced for female participants (p for interaction = 0.005).Conclusions: In this cohort study, lean patients with NAFLD had a risk of incident type 2 diabetes similar to that of overweight/obese ones with NAFLD. These findings suggest that lean NAFLD is not a benign condition. Further investigations are needed to gain a better understanding of the pathogenesis and natural history of NAFLD in lean subjects.

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