Evaluation of ultrasonographic fatty liver and severity of coronary atherosclerosis, and obesity in patients undergoing coronary angiography.
OBJECTIVE
Aims were to examine associations (1) between non-alcoholic fatty liver disease (NAFLD) and the presence and severity of coronary artery disease (CAD) and obesity, (2) between CAD and NAFLD with aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamiltransferase (GGT) levels.


METHODS
In this cross-sectional study, the study group consisted of 355 patients (mean age: 57.5+/-11.4 years), that comply with inclusion criteria and selected of 414 consecutive patients who underwent coronary angiographies. Coronary artery disease was defined as a stenosis at least 50% in at least one major coronary artery. Modified Gensini scoring was used to determine the severity of coronary atherosclerosis. Fatty liver was diagnosed by abdominal ultrasonography (4 stages: Grades 0, 1, 2 and 3). Obesity was defined as body mass index (BMI) >or=30 kg/m2. Statistical evaluations were performed using Student's t test, ANOVA, Chi- square, kappa tests and logistic regression analysis.


RESULTS
There were significant differences among Grades 0, 1 and 2-3 according to presence of CAD and Gensini score. In univariate analysis, age (OR=1.03, p=0.004), gender (OR=3.05, p<0.0001), dyslipidemia (OR=4.40, p<0.0001), diabetes mellitus (OR=2.15, p=0.048), smoking (OR=3.19, p<0.0001), AST (OR=1.01, p=0.042), GGT (OR=1.04, p<0.0001), NAFLD (OR=1.87, p=0.036) and obesity+NAFLD (OR: 2.1, p=0.018) have effects on presence of CAD. In multivariate model, age (OR=1.04, p<0.001), AST (OR=1.01, p<0.05), GGT (OR=1.04, p<0.001), NAFLD (OR=2.58, p<0.01) have independent effects on CAD; however BMI and obesity were ineffective. Non-alcoholic fatty liver disease has an independent effect on Gensini score (OR=2.02, p<0.05).


CONCLUSIONS
Ultrasonographic fatty liver have independent effects on both the presence of CAD and severity of coronary atherosclerosis. In addition, increased serum AST and GGT levels may be independently associated with CAD.
Açikel
Mahmut
M
Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey. macikel@hotmail.com
Sunay
Sadik
S
Koplay
Mustafa
M
Gündoğdu
Fuat
F
Karakelleoğlu
Sule
S
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000201:enzymology / Q000209:etiology / Q000473:pathology*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000201:enzymology / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000201:enzymology / Q000473:pathology; D012720:Severity of Illness Index; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase