The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans.
OBJECTIVE
Non-alcoholic fatty liver disease (NAFLD) is known to be related to factors that predict the development of coronary heart disease (CHD), such as dyslipidemia, central obesity, and metabolic syndrome (MS). The aim of this study was to determine whether individuals with NAFLD have an elevated risk of CHD, as estimated using the Framingham risk score (FRS).


METHODS
A total of 21,130 individuals who underwent a voluntary general health examination were recruited. NAFLD was diagnosed among these individuals on the basis of typical sonographic findings and a level of alcohol consumption of <20 g/day. Of the 21,130 individuals, 3,780 were excluded because they had known causes of liver disease (1,690 were alcoholics, 975 had hepatitis B virus, 242 had hepatitis C virus, 91 had other hepatitis history, and 593 were taking medication known to produce fatty liver) or a history of heart disease (189).


RESULTS
NAFLD was diagnosed in 5,769 of the 17,350 individuals (33.3%). The 11,581 normal individuals constituted the control group. The 5,769 individuals with NAFLD were split into two groups on the basis of ultrasonographic findings, that is, into a mild NAFLD group (n=3,278) and a moderate-severe NAFLD group (n=2,491). Individuals with NAFLD had an elevated risk of CHD, as estimated using FRS. Multivariable regression analysis, adjusted for confounding factors, showed a strong association between a higher FRS and NAFLD.


CONCLUSIONS
Individuals with ultrasonographically detected NAFLD have an elevated 10-year risk of developing CHD as estimated using FRS. Furthermore, NAFLD was found to be independently related to the risk of developing CHD, regardless of classical risk factors and other components of MS.
Choi
Su-Yeon
SY
Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, Korea.
Kim
Donghee
D
Kim
Hwa Jung
HJ
Kang
Jin Hwa
JH
Chung
Su Jin
SJ
Park
Min Jung
MJ
Kim
Young Sun
YS
Kim
Chung Hyun
CH
Choi
Seung Ho
SH
Kim
Won
W
Kim
Yoon Jun
YJ
Yoon
Jung-Hwan
JH
Lee
Hyo-Suk
HS
Cho
Sang-Heon
SH
Sung
Myung-Whun
MW
Oh
Byung-Hee
BH
D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors