Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease.
OBJECTIVE
To clarify whether nonalcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular disease.


METHODS
We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program. NAFLD was diagnosed by abdominal ultrasonography. The metabolic syndrome (MS) was defined according to the modified National Cholesterol Education Program (NCEP) ATP III criteria. Five years after the baseline evaluations, the incidence of cardiovascular disease was assessed by a self-administered questionnaire.


RESULTS
Among 1221 participants available for outcome analyses, the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline (5 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage) than 990 subjects without NAFLD (3 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage). Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors (odds ratio 4.12, 95% CI, 1.58 to 10.75, P = 0.004). MS was also independently associated with cardiovascular events. But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.


CONCLUSIONS
Although both of them were predictors of cardiovascular disease, NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model. NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.
Hamaguchi
Masahide
M
Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan. seele@mbox.kyoto-inet.or.jp
Kojima
Takao
T
Takeda
Noriyuki
N
Nagata
Chisato
C
Takeda
Jun
J
Sarui
Hiroshi
H
Kawahito
Yutaka
Y
Yoshida
Naohisa
N
Suetsugu
Atsushi
A
Kato
Takahiro
T
Okuda
Junichi
J
Ida
Kazunori
K
Yoshikawa
Toshikazu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis*; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography