title: Hepatic steatosis is associated with aortic valve sclerosis in the general population: the Study of Health in Pomerania (SHIP).
abstract: OBJECTIVE
  We aimed to analyze the association between hepatic steatosis and aortic valve sclerosis in the general population.
  
  
  RESULTS
  Cross-sectional data of 2212 men and women, aged 45 to 81 years, from the baseline examination of the population-based Study of Health in Pomerania (SHIP-0) were analyzed. Hepatic steatosis was primarily defined as the presence of a hyperechogenic ultrasound pattern of the liver. Aortic valve sclerosis was determined by echocardiography. In our sample, hepatic steatosis was present in 877 (39.7%) individuals. Among participants with hepatic steatosis, aortic valve sclerosis was more common (n=323; 36.8%) compared with participants without hepatic steatosis (n=379; 28.4%; P<0.001). After adjustment for potential confounders, individuals with hepatic steatosis had 33% higher odds of aortic valve sclerosis compared with those without hepatic steatosis (95% confidence interval, 6%-66%; P=0.014). Additional adjustment for high-sensitive C-reactive protein, serum ferritin levels, and white blood cells slightly reduced the association to 32% (95% confidence interval, 4%-66%; P=0.021).
  
  
  CONCLUSIONS
  Our findings add evidence that hepatic steatosis and aortic valve sclerosis are interrelated after adjustment for major confounders. The release of proatherogenic substances by the steatotic liver or its contribution to insulin resistance and dyslipidemia may contribute to the development of calcification and sclerosis of the aortic valve.
authors.affiliation: Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. marcello.markus@unigreifswald.de
authors.forename: Marcello Ricardo Paulista
authors.initials: MR
authors.lastname: Markus
authors.forename: Sebastian Edgar
authors.initials: SE
authors.lastname: Baumeister
authors.forename: Jan
authors.initials: J
authors.lastname: Stritzke
authors.forename: Marcus
authors.initials: M
authors.lastname: Dörr
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006349:Heart Valve Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012598:Sclerosis
chemical_list: D015415:Biomarkers
keywords: aortic valve sclerosis; atherosclerosis; nonalcoholic fatty liver disease; risk factors; visceral steatosis, congenital