title: Association Between Quantity of Liver Fat and Cardiovascular Risk in Patients With Nonalcoholic Fatty Liver Disease Independent of Nonalcoholic Steatohepatitis.
abstract: OBJECTIVE
  The association between quantity of liver fat and the presence of metabolic syndrome needs to be assessed systematically. We aimed to determine the association between the quantity of liver fat and the presence of the metabolic syndrome in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD), independent of nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  We recruited 146 patients with well-characterized biopsy-proven NAFLD and 50 individuals without NAFLD (controls) to participate in a case-control study at the NAFLD Translational Research Unit at the University of California San Diego. Liver fat was quantified in patients with NAFLD and controls using an advanced magnetic resonance imaging-based biomarker, the proton-density-fat-fraction (MRI-PDFF). Patients with NAFLD were divided into groups based on whether they were above or below the median MRI-PDFF value (15.4% in patients with NAFLD); the MRI-PDFF value for controls was less than 5%. The primary outcome was the presence of the metabolic syndrome using Adult Treatment Panel III criteria without and with adjustment for the presence of NASH.
  
  
  RESULTS
  Compared with NAFLD patients with MRI-PDFF values below the median, and compared with controls, NAFLD patients with MRI-PDFF values above the median were more likely to have abdominal obesity (P < .0001), lower levels of high-density cholesterol (P < .0001), higher levels of triglycerides (P < .0001), and higher fasting glucose levels (P < .001). Compared with NAFLD patients with MRI-PDFF values below the median, NAFLD patients with MRI-PDFF above the median were more likely to have the metabolic syndrome (60.3% vs. 44.4%; P < .04), independent of biopsy-detected NASH.
  
  
  CONCLUSIONS
  Increased liver fat content in patients with NAFLD is associated with increased rates of the metabolic syndrome, independent of NASH. There appears to be an association between the quantity of liver fat and the risk for cardiovascular disease in patients with NAFLD.
authors: Division of Internal Medicine, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
authors: Ahilan
authors: A
authors: Arulanandan
authors: NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
authors: Brandon
authors: B
authors: Ang
authors: Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, California.
authors: Ricki
authors: R
authors: Bettencourt
authors: Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California.
authors: Jonathan
authors: J
authors: Hooker
authors: Department of Pathology, University of California San Diego School of Medicine, La Jolla, California.
authors: Cynthia
authors: C
authors: Behling
authors: Department of Pathology, University of California San Diego School of Medicine, La Jolla, California.
authors: Grace Y
authors: GY
authors: Lin
authors: Department of Pathology, University of California San Diego School of Medicine, La Jolla, California.
authors: Mark A
authors: MA
authors: Valasek
authors: Division of Nephrology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
authors: Joachim H
authors: JH
authors: Ix
authors: NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
authors: Bernd
authors: B
authors: Schnabl
authors: Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California.
authors: Claude B
authors: CB
authors: Sirlin
authors: NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, California. Electronic address: roloomba@ucsd.edu.
authors: Rohit
authors: R
authors: Loomba
mesh_terms: D000328:Adult; D000368:Aged; D002140:California; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D018570:Risk Assessment
keywords: Cardiovascular Disease; Cardiovascular Risk; Detection; Heart and Vascular Disease; Liver Fat; Magnetic Resonance Imaging; Nonalcoholic Steatohepatitis; Noninvasive; Noninvasive Biomarker; Prognostic Factor