title: Hepatic fibrosis assessed using transient elastography independently associated with coronary artery calcification.
abstract: Non-alcoholic fatty liver disease (NAFLD) has a close relationship with coronary atherosclerosis. We investigated the association between coronary atherosclerosis and liver fibrosis, represented as coronary artery calcification (CAC) score, and live stiffness (LS) value assessed using transient elastography (TE), respectively, in patients with NAFLD.
  
  
  
  Between January 2013 and March 2014, a total of 285 asymptomatic subjects without chronic liver and ischemic heart diseases who underwent comprehensive medical health check-up were recruited. NAFLD was defined as controlled attenuation parameter (CAP) ≥ 250 dB/m on TE.
  
  
  
  The median age of the study population (men 161 and women 124) was 56 (interquartile [IQR], 50-63) years. Of these, 142 (49.8%) subjects had NAFLD. Among subjects with NAFLD, CAC score was independently correlated with the male gender (β = 0.230; P = 0.010), elevated erythrocyte sedimentation rate (β = 0.220; P = 0.019), reduced estimated glomerular filtration rate (β=-0.220; P = 0.004), increased left ventricular mass index (β = 0.226; P = 0.027), and higher LS values (β = 0.274; P < 0.001). In addition, alanine aminotransferase level (β = 0.214, P = 0.012) and CAC score (β = 0.311; P = 0.001) are the only independent factors associated with LS values in subjects with NAFLD.
  
  
  
  Higher CAC score was independently correlated with LS values in subjects with NAFLD. However, it should be further investigated whether TE can be incorporated into a screening tool to identify the high-risk population for coronary artery disease.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seng Chan
authors.initials: SC
authors.lastname: You
authors.affiliation: Severance Executive Healthcare Clinic, Yonsei University Health System, Seoul, Korea.|Severance Check-up Severance Hospital, Yonsei University Health System, Seoul, Korea.
authors.forename: Kwang Joon
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Beom Kyung
authors.initials: BK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D002114:Calcinosis; D003324:Coronary Artery Disease / Q000150:complications*; D003327:Coronary Disease / Q000150:complications*; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000503:physiopathology; D012189:Retrospective Studies; D012737:Sex Factors
keywords: coronary artery calcification; fibroscan; healthy subjects; liver fibrosis; liver stiffness; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; transient elastography