title: Sex-influenced association of nonalcoholic fatty liver disease with coronary heart disease.
abstract: OBJECTIVE
  This study investigated whether nonalcoholic fatty liver disease (NAFLD) predicts prevalent coronary heart disease (CHD).
  
  
  METHODS
  Epidemiologic studies have used various definitions for NAFLD. Here, we considered both liver fat burden measured by CT (FL) and the non-specific measure of hepatic inflammation -alanine aminotransferase (ALT). The association of FL and ALT with CHD (self report of coronary bypass, myocardial infarction, or percutaneous transluminal coronary angioplasty) was investigated in 2756 European-American participants of the Family Heart Study.
  
  
  RESULTS
  FL (p = 0.0084) and ALT (≥40 U/L, p = 0.014) were each individually associated with prevalent CHD. However, when accounting for traditional metabolic risk factors in a multivariate model FL had no predictive value for CHD in either men or women; whereas ALT was a significant predictor of CHD in men, and the association strengthened among non-diabetic men. In non-diabetic women, neither FL nor ALT was associated with CHD.
  
  
  CONCLUSIONS
  ALT (≥40 U/L) was a predictor of prevalent CHD in men but not in women, while CT measured FL was not significant in either sex. The failure to account for traditional risk factors, heterogeneity by sex, and varying definitions of NAFLD may account for some of the conflicting evidence in the literature regarding the association between NAFLD and coronary disease.
authors: Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, 4444 Forest Park Blvd, Saint Louis, MO 63108-2212, Campus Box 8506, USA. mfeitosa@wustl.edu
authors: Mary F
authors: MF
authors: Feitosa
authors: Alexander P
authors: AP
authors: Reiner
authors: Mary K
authors: MK
authors: Wojczynski
authors: Mariaelisa
authors: M
authors: Graff
authors: Kari E
authors: KE
authors: North
authors: Jeffrey J
authors: JJ
authors: Carr
authors: Ingrid B
authors: IB
authors: Borecki
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D017130:Angioplasty / Q000379:methods; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease; D018384:Oxidative Stress; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000410:Alanine Transaminase
references: Ann Intern Med. 2005 Nov 15;143(10):722-8
references: 16287793
references: Clin J Am Soc Nephrol. 2011 Apr;6(4):767-74
references: 21441124
references: J Gastroenterol Hepatol. 2009 Aug;24(8):1411-6
references: 19702910
references: Diabetes Care. 2007 May;30(5):1212-8
references: 17277038
references: Dig Dis Sci. 2010 Mar;55(3):560-78
references: 20101463
references: Dig Dis Sci. 2011 Jan;56(1):35-45
references: 20464495
references: CMAJ. 2005 Feb 1;172(3):367-79
references: 15684121
references: Arterioscler Thromb Vasc Biol. 2007 Dec;27(12):2729-35
references: 17932318
references: Atherosclerosis. 2006 Nov;189(1):198-205
references: 16405892
references: Semin Thorac Cardiovasc Surg. 2011 Summer;23(2):126-30
references: 22041042
references: Dig Dis Sci. 2011 Dec;56(12):3439-49
references: 21655948
references: Hepatology. 2009 Nov;50(5):1403-11
references: 19670414
references: N Engl J Med. 2002 Apr 18;346(16):1221-31
references: 11961152
references: AJR Am J Roentgenol. 2010 Mar;194(3):623-8
references: 20173137
references: Am J Gastroenterol. 2008 Dec;103(12):3029-35
references: 18853970
references: Hepatology. 2004 Dec;40(6):1387-95
references: 15565570
references: Clin Chem. 1972 Jun;18(6):499-502
references: 4337382
references: Hepatology. 2006 May;43(5):1145-51
references: 16628637
references: J Gastroenterol Hepatol. 2002 Nov;17(11):1136-43
references: 12453271
references: Clin Sci (Lond). 2009 Apr;116(7):539-64
references: 19243311
references: Diabetes Metab Res Rev. 2006 Nov-Dec;22(6):437-43
references: 16832839
references: Hepatology. 2003 Apr;37(4):917-23
references: 12668987
references: Am J Epidemiol. 1996 Jun 15;143(12):1219-28
references: 8651220
references: World J Gastroenterol. 2007 Mar 14;13(10):1579-84
references: 17461452
references: Clin Chem Lab Med. 2010 Dec;48(12):1829-34
references: 20961204
references: AJR Am J Roentgenol. 2007 May;188(5):1307-12
references: 17449775
references: J Mol Med (Berl). 2009 Jul;87(7):679-95
references: 19352614
references: N Engl J Med. 2010 Sep 30;363(14):1341-50
references: 20879883