Non-alcoholic fatty liver disease, metabolic syndrome and subclinical cardiovascular changes in the general population.
OBJECTIVE
The effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular system remains controversial. We investigated the independent contribution of NAFLD to cardiovascular structure and function in the general population.


METHODS
A total of 1886 participants without known cardiovascular disease were enrolled from the Korean Genome Epidemiology Study. The participants were divided into four groups, based on the presence of NAFLD, metabolic syndrome (MetS), neither or both. NAFLD was diagnosed by CT. Changes in cardiovascular structure and function were assessed by tissue Doppler imaging (TDI) echocardiography, carotid ultrasound and brachial-ankle pulse wave velocity (baPWV).


RESULTS
In multivariate analyses, subjects with both NAFLD and MetS had a higher E/Ea ratio and baPWV, as well as a lower TDI Ea velocity (all p<0.001) than those with neither NAFLD nor MetS. Subjects with either NAFLD or MetS also showed significant differences in TDI Ea velocity and baPWV (all p<0.05). However, no significant differences of carotid intima-media thickness (CIMT) values were seen among the four groups. Multivariate linear regression revealed that both NAFLD and MetS were independent predictors of TDI Ea velocity and baPWV (all p<0.001). Both MetS and NAFLD were not a determinant of CIMT.


CONCLUSIONS
NAFLD was associated with early alterations of cardiovascular system, independent of established cardiovascular risk factors and MetS.
Division of Endocrinology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Nan Hee
NH
Kim
Division of Endocrinology, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
Juri
J
Park
Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Seong Hwan
SH
Kim
Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Yong Hyun
YH
Kim
Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Dong Hyuk
DH
Kim
Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Goo-Yeong
GY
Cho
Department of Foods and Nutrition, College of Natural Sciences, Kookmin University, Seoul, Korea.
Inkyung
I
Baik
Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
Hong Euy
HE
Lim
Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
Eung Ju
EJ
Kim
Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
Jin Oh
JO
Na
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
Jung Bok
JB
Lee
Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea.
Seung Ku
SK
Lee
Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea.
Chol
C
Shin
D000368:Aged; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed