Fatty liver, abdominal adipose tissue and atherosclerotic calcification in African Americans: the Jackson Heart Study.
OBJECTIVE
Both fatty liver and abdominal visceral fat (VAT) are associated with cardiometabolic risk factors. Whether fatty liver and VAT are jointly associated with coronary artery (CAC) or abdominal aortic (AAC) calcification is not clear.


METHODS
Jackson Heart Study (JHS) participants (n = 2884, mean age 60 years, 65% women) underwent non-contrast CT Exam for assessment of fatty liver, VAT, and CAC and AAC. Fatty liver was measured by liver attenuation (LA; low LA = high fatty liver). The Agatston score was used to quantify the amount of calcified artery plaque and the presence of calcified artery plaque was defined as Agatston score>0. Cross-sectional associations of LA and VAT with CAC and AAC were examined in logistic regression models.


RESULTS
LA (per 1-standard deviation [SD] decrement) was associated inversely with CAC in age-sex-adjusted (OR 0.84, 95%CI 0.7-0.9, p = 0.0001) and multivariable-adjusted models (OR 0.89, 95%CI 0.8-0.9, p = 0.01). The association persisted for LA with CAC when additionally adjusted for body mass index (BMI) (OR 0.89, 95%CI 0.8-0.9, p = 0.03) or VAT (OR 0.90, 95%CI 0.8-0.9, p = 0.04). Abdominal VAT (per 1-SD increment) was positively associated with CAC in age-sex-adjusted models (OR 1.27, 95%CI 1.2-1.4, p = 0.0001), but the association was diminished with multivariable adjustment (OR 1.10, 95%CI 0.9-1.2, p = 0.09) and with additional adjustment for LA (p = 0.24) or BMI (p = 0.33). For AAC, the associations with LA and VAT were only present in age-sex-adjusted models. Finally, we did not observe interactions between LA and VAT for CAC (p = 0.18) or AAC (p = 0.24).


CONCLUSIONS
Fatty liver is associated with coronary atherosclerotic calcification independent of abdominal VAT or BMI in African Americans. Further investigations to uncover the clinical implications of fatty liver on coronary atherosclerosis in obesity are warranted.
Jackson Heart Study, University of Mississippi Medical Center, 350 W Woodrow Wilson Dr, Jackson State University, Jackson, MS 39213-4505, USA. jliu@umc.edu
Jiankang
J
Liu
Solomon K
SK
Musani
Aurelian
A
Bidulescu
J Jeffery
JJ
Carr
James G
JG
Wilson
Herman A
HA
Taylor
Caroline S
CS
Fox
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D050154:Adiposity / Q000208:ethnology; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000208:ethnology*; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000208:ethnology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging / Q000208:ethnology*; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000208:ethnology*; D055815:Young Adult