title: Presence of coronary plaques in patients with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  To evaluate the relationship between nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) and to define determinants of CAD in patients with or without metabolic syndrome.
  
  
  METHODS
  This study was approved by the local ethics committee; informed consent was obtained. Twenty-nine subjects (mean age, 53 years +/- 7 [standard deviation]) with low to intermediate risk for CAD and with fatty liver were included. Thirty-two sex- and age-matched individuals without NAFLD served as controls. CAD was defined as a stenosis of more than 50% in at least one major coronary artery. Fatty liver was assessed by means of an attenuation of -10 HU or higher (calculated as liver attenuation minus spleen attenuation) by using computed tomography (CT), coronary plaques and stenosis by using CT coronary angiography, and biomarkers of insulin resistance, lipotoxicity, systemic inflammation, and oxidant and antioxidant status. A logistic regression analysis was performed to study multivariable associations.
  
  
  RESULTS
  When compared with controls, NAFLD patients showed a higher prevalence of calcified and noncalcified coronary plaques (67% vs 34% and 52% vs 29%, respectively; both P < .001), higher prevalence of nonobstructive coronary stenosis (34% vs 14%; P < .008), higher homeostasis model assessment of insulin resistance (3.8 epsilonU/mL +/- 3.6 vs 2.6 epsilonU/mL +/- 3.2; P < .005) and higher triglyceride levels (208 mg/dL +/- 87 vs 148 mg/dL +/- 70; P < .005). Fatty liver proved to be a strong predictor of coronary atherosclerosis (odds ratio [OR], 2; P < .04), independent of indicators for metabolic syndrome (OR, 1.2; P > .2) and C-reactive protein levels (OR, 0.7; P > .4).
  
  
  CONCLUSIONS
  Patients with NAFLD, even without metabolic syndrome, are at high risk for atherosclerosis. Assessment of NAFLD may be helpful for cardiovascular risk stratification.
authors.affiliation: Liver Unit, Ziv Medical Centre, Box 1008, Safed 13100, Israel. assy.n@ziv.health.gov.il
authors.forename: Nimer
authors.initials: N
authors.lastname: Assy
authors.forename: Agness
authors.initials: A
authors.lastname: Djibre
authors.forename: Raymond
authors.initials: R
authors.lastname: Farah
authors.forename: Maria
authors.initials: M
authors.lastname: Grosovski
authors.forename: Alon
authors.initials: A
authors.lastname: Marmor
mesh_terms: D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol