title: Nonalcoholic fatty liver disease is associated with significant coronary artery disease in type 2 diabetic patients: a computed tomography angiography study 2：.
abstract: BACKGROUND
  To investigate whether nonalcoholic fatty liver disease (NAFLD) is associated with coronary artery disease (CAD) in type 2 diabetic patients, who underwent coronary computed tomography angiography (CTA).
  
  
  METHODS
  Between June 2007 and May 2010, a total of 273 type 2 diabetic patients without known liver disease underwent coronary CTA for chest pain were enrolled. Axial, multiplanar, and Maximum intensity projection (MIP) images were used for determining the cardiovascular disease. Liver fat content was measured from unenhanced CT images obtained for calcium scoring. Moderate and severe NAFLD was defined when mean liver attenuation value is ≤40 Hounsfield Unit (HU).
  
  
  RESULTS
  Among 273 patients, 76% of the patients (n = 207) had CAD; 48% of them had significant CAD (≥50 stenosis) by coronary CTA. Patients with CAD were older and male gender was predominant. Mean liver attenuation value calculated with CT was 50 ± 12 HU. Mean liver attenuation value was lower in patients with metabolic syndrome compared to patients without metabolic syndrome (P < 0.001). Moderate and severe NAFLD was observed in 22% of the patients (n = 59) with a mean attenuation value of 30 HU. After adjustment of age, gender, obesity, hypertension, smoking status and serum low-density lipoprotein (LDL) levels as coronary risk factors, NAFLD was associated with significant CAD (P = 0.04).
  
  
  CONCLUSIONS
  In conclusion, the results of the present study indicate that NAFLD is associated with significant CAD in type 2 diabetic patients. Assessment of liver attenuation by CT represents noninvasive evaluation for detection of asymptomatic individuals with NAFLD during coronary CT angiography.
authors.affiliation: Division of Noninvasive Cardiovascular Imaging, Hacettepe University School of Medicine, Ankara, Turkey; Liver Imaging Team, Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Ilkay S
authors.initials: IS
authors.lastname: Idilman
authors.forename: Deniz
authors.initials: D
authors.lastname: Akata
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazirolan
authors.forename: Beyza
authors.initials: B
authors.lastname: Doganay Erdogan
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Musturay
authors.initials: M
authors.lastname: Karcaaltincaba
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001786:Blood Glucose
keywords: coronary artery disease; coronary computed tomography angiography; nonalcoholic fatty liver disease; type 2 diabetes mellitus; 关键词：冠心病，冠状动脉计算机断层扫描血管造影，非酒精性脂肪性肝病，2型糖尿病