title: Nonalcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Recent epidemiological data suggest that non-alcoholic fatty liver disease (NAFLD) is closely associated with aortic valve sclerosis (AVS), an emerging risk factor for adverse cardiovascular outcomes, in nondiabetic and type 2 diabetic individuals. To date, nobody has investigated the association between NAFLD and AVS in people with type 2 diabetes, a group of individuals in which the prevalence of these two diseases is high.
  
  
  RESULTS
  We recruited 180 consecutive type 2 diabetic patients without ischemic heart disease, valvular heart disease, hepatic diseases or excessive alcohol consumption. NAFLD was diagnosed by liver ultrasonography whereas AVS was determined by conventional echocardiography in all participants. In the whole sample, 120 (66.7%) patients had NAFLD and 53 (29.4%) had AVS. No patients had aortic stenosis. NAFLD was strongly associated with an increased risk of prevalent AVS (odds ratio [OR] 2.79, 95% CI 1.3-6.1, p<0.01). Adjustments for age, sex, duration of diabetes, diabetes treatment, body mass index, smoking, alcohol consumption, hypertension, dyslipidemia, hemoglobin A1c and estimated glomerular filtration rate did not attenuate the strong association between NAFLD and risk of prevalent AVS (adjusted-OR 3.04, 95% CI 1.3-7.3, p = 0.01).
  
  
  CONCLUSIONS
  Our results provide the first demonstration of a positive and independent association between NAFLD and AVS in patients with type 2 diabetes mellitus.
authors: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors: Stefano
authors: S
authors: Bonapace
authors: Division of General Medicine "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors: Filippo
authors: F
authors: Valbusa
authors: Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors: Lorenzo
authors: L
authors: Bertolini
authors: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Isabella
authors: I
authors: Pichiri
authors: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Alessandro
authors: A
authors: Mantovani
authors: Section of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Andrea
authors: A
authors: Rossi
authors: Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors: Luciano
authors: L
authors: Zenari
authors: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors: Enrico
authors: E
authors: Barbieri
authors: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Giovanni
authors: G
authors: Targher
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D004452:Echocardiography; D005234:Fatty Liver / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012044:Regression Analysis