title: Nonalcoholic fatty liver disease is associated with coronary artery disease in Koreans.
abstract: OBJECTIVE
  To investigate whether nonalcoholic fatty liver disease (NAFLD) affects coronary artery disease (CAD) and identify candidate mediators.
  
  
  METHODS
  Patients who underwent coronary angiography were consecutively recruited. The patients were classified into four groups by coronary artery stenosis: A, insignificant; B, one-vessel disease; C, two-vessel disease; and D, three-vessel disease. Abdominal ultrasonography was performed to determine the presence of a fatty liver and categorize by grade: 0, no evidence; 1, mild; 2, moderate; and 3, severe. We measured not only known CAD risk factors, but also serum insulin, HOMA-index, adiponectin, interleukin-6, tumor necrosis factor-α and high-sensitivity C-reactive protein levels.
  
  
  RESULTS
  Of the 134 patients who met the inclusion criteria, 82 (61.2%) had ultrasonographically diagnosed NAFLD. Among the 46 patients with CAD, 37 (80.4%) had evidence of a fatty liver. The two groups (A vs B-D) were significantly different in terms of age, total cholesterol, triglycerides, low-density lipoprotein levels and fatty liver. Coronary artery stenosis was strongly associated with fatty liver in a grade-dependent manner (P = 0.025). In binary logistic regression, NAFLD was a significant independent predictor of CAD (P = 0.03, OR = 1.685; 95%CI: 1.051-2.702). Among the candidate mediators, the serum adiponectin level showed a trend toward lowering based on CAD progression (P = 0.071).
  
  
  CONCLUSIONS
  NAFLD is an independent risk factor for CAD in a grade-dependent manner. Moreover, adiponectin might be related to the pathogenesis of NAFLD.
authors.affiliation: Dae Hee Choi, Sung Joon Lee, Chang Don Kang, Myoung Ok Park, Dong Wook Choi, Tae Suk Kim, Wonho Lee, Byung Ryul Cho, Yong Hoon Kim, Bong-ki Lee, Dong Ryeol Ryu, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 200-701, South Korea.
authors.forename: Dae Hee
authors.initials: DH
authors.lastname: Choi
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Lee
authors.forename: Chang Don
authors.initials: CD
authors.lastname: Kang
authors.forename: Myoung Ok
authors.initials: MO
authors.lastname: Park
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Tae Suk
authors.initials: TS
authors.lastname: Kim
authors.forename: Wonho
authors.initials: W
authors.lastname: Lee
authors.forename: Byung Ryul
authors.initials: BR
authors.lastname: Cho
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Bong-ki
authors.initials: BK
authors.lastname: Lee
authors.forename: Dong Ryeol
authors.initials: DR
authors.lastname: Ryu
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index; D014463:Ultrasonography
keywords: Adiponectin; Coronary angiography; Coronary artery disease; Insulin resistance; Nonalcoholic fatty liver disease