title: Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease.
abstract: 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.
authors.affiliation: Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan. seele@mbox.kyoto-inet.or.jp
authors.forename: Masahide
authors.initials: M
authors.lastname: Hamaguchi
authors.forename: Takao
authors.initials: T
authors.lastname: Kojima
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takeda
authors.forename: Chisato
authors.initials: C
authors.lastname: Nagata
authors.forename: Jun
authors.initials: J
authors.lastname: Takeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sarui
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawahito
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yoshida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suetsugu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kato
authors.forename: Junichi
authors.initials: J
authors.lastname: Okuda
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ida
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: 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