Nonalcoholic Fatty Liver Disease as a Risk Factor for Cardiovascular Disease: Using the Estimation of Framingham Risk Score and Carotid Artherosclerosis

ABSTRACT

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is known to be associated with obesity, type 2 diabetes, and dyslipidemia and highly related to metabolic syndrome. The purpose of this study was to examine NAFLD as a risk factor for cardiovascular disease using the Framingham risk score and carotid intima media thickness. METHODS: We examined 189 Korean adults older than 20 years who participated in a health screening test and had both carotid and abdominal ultrasounds. Patients with viral hepatitis and history of cardiovascular disease and alcohol consumption (>20 g/day) were excluded. We compared clinical characteristics, the Framingham risk scores, and carotid intima media thickness according to the presence of nonalcoholic fatty liver disease. RESULTS: Framingham risk scores and the estimated 10-year risk for coronary heart disease were higher in subjects with NAFLD (11.5+/-4.7 vs 10.2+/-4.3 P=0.04, 8.7+/-7.3% vs 4.9+/-5.0% P<0.001). Carotid intima media thickness was higher in subjects with NAFLD (0.72+/-0.18 mm) compared to the controls (0.63+/-0.15 mm) (P<0.001). This result persisted significantly after adjusting for age, sex, and the 5 components of metabolic syndrome. Multiple logistic regression analysis showed that the presence of NAFLD (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.495-5.812) and triglyceride level (OR, 2.06; 95% CI, 1.041-4.066) were independently related with carotid atherosclerosis. CONCLUSIONS: These results suggest that NAFLD is a risk factor for cardiovascular disease. Physicians should be mindful of this association when seeing patients with NAFLD.