Clinical and pathologic risk factors for atherosclerosis in cirrhosis: a comparison between NASH-related cirrhosis and cirrhosis due to other aetiologies.
OBJECTIVE
The precise prevalence of risk factors for atherosclerosis in NASH-related cirrhosis is unknown. The aims of this study were: (1) to compare the prevalence of major risk factors for atherosclerosis between subjects who underwent liver transplantation for NASH-related cirrhosis and those with cirrhosis of other aetiologies and (2) to compare pathologic changes of atherosclerosis within the explants hepatic hilar arteries between the groups.


METHODS
Sixty subjects with NASH-related cirrhosis and 60 subjects with cirrhosis of other aetiologies were reviewed retrospectively. Demographic and clinical characteristics related to atherosclerosis were analyzed and compared. The hepatic hilar arteries of the explanted livers were examined for pathologic changes.


RESULTS
The prevalence of all coronary artery disease (CAD) risk factors and the metabolic syndrome was significantly higher in NASH-related cirrhosis group compared to cirrhosis of other aetiologies. The proportion of patients with a diagnosis of CAD was also significantly higher in the NASH-related cirrhosis group (21.6% vs. 5%, p=0.005). Pathological examination of hilar arteries showed possible atherosclerotic changes in only 4 cases (3 NASH-related cirrhosis; 1 HCV).


CONCLUSIONS
Major risk factors for atherosclerosis are significantly more prevalent in subjects with NASH-related cirrhosis than in subjects with cirrhosis of other aetiologies and are predictive of an increased prevalence of CAD. This study suggests that NASH-related cirrhosis is not protective against atherosclerosis.
Kadayifci
Abdurrahman
A
Division of Gastroenterology, University of California San Francisco, San Francisco, CA, USA. kadayifci@hotmail.com
Tan
Vivian
V
Ursell
Philip C
PC
Merriman
Raphael B
RB
Bass
Nathan M
NM
D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology* / Q000473:pathology*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000473:pathology; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors