Introduction:
We sought to characterize the association of three adiposity-related risk factors - obesity, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) - with the outcomes of increased inflammation and subclinical atherosclerosis.
Methods:
We conducted a cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with adequate CT imaging to diagnose NAFLD. For the study exposures, obesity was defined as BMI ≥30 kg/m
2
, metabolic syndrome by ATP III criteria, and NAFLD using non-contrast cardiac CT and a liver/spleen attenuation ratio (L/S) 0. In order to assess for a possible gradient-response, adjusted logistic regression was used to examine the association of a stepwise increase in the number of three adiposity-related risk factors with increased inflammation and subclinical atherosclerosis. Additional models were conducted stratifying by gender or ethnicity.
Results:
Mean age of participants was 63 years, 45% were male, 37% were white, 10% Chinese, 30% African American, and 23% Hispanic. NAFLD was associated with an odds ratio for high hs-CRP and CAC>0 of 1.54 (1.27-1.87) and 1.41 (1.15-1.73), respectively, adjusting for obesity, metabolic syndrome and traditional risk factors. There was a positive interaction between female gender and NAFLD in the association with high hs-CRP (p=0.01). There was no interaction by race. Importantly, with increasing number of adiposity-related risk factors, the odds ratios of high hs-CRP and CAC>0 increased in a graded fashion, suggesting a collective association (Figure).
Conclusion:
There is an association between three adiposity-related risk factors - obesity, metabolic syndrome, and NAFLD - with both increased inflammation and subclinical coronary atherosclerosis.
Association of Adolescent Obesity with Nonalcoholic Fatty Liver Disease and Related Risk Factors in Xi ’an, China
