title: Higher association of coronary artery calcification with non-alcoholic fatty liver disease than with abdominal obesity in middle-aged Korean men: the Kangbuk Samsung Health Study.
abstract: BACKGROUND
  It is uncertain whether non-alcoholic fatty liver disease (NAFLD) or abdominal obesity is more associated with atherosclerosis. The aim of this study was to determine whether NAFLD or abdominal obesity is more strongly associated with subclinical atherosclerosis represented by coronary artery calcification (CAC).
  
  
  METHODS
  A total of 21,335 male participants in a health screening program (mean age 41 years) were enrolled. Ultrasonographic measurements of fatty liver and multi-detector computed tomography were performed to determine the coronary artery calcium score (CACS). The presence of CAC was defined as CACS > 0. Subjects were divided into four groups according to the presence or absence of NAFLD and/or abdominal obesity as assessed by waist-hip ratio (WHR) > 0.9.
  
  
  RESULTS
  The presence of CAC was detected in 2,385 subjects (11.2%). The proportion of subjects with CAC was highest in the abdominal obesity only group (23.2%). After adjustment for age, diabetes history, hypertension, cigarette smoking, and physical inactivity, the odds ratio (OR) for CAC was the highest in the group with both abnormalities [1.465 (1.324-1.623)]. The NAFLD only group showed significantly increased OR for CAC compared to that in the abdominal obesity only group [1.286 (1.151-1.436) vs. 1.076 (0.939-1.233)].
  
  
  CONCLUSIONS
  Non-alcoholic fatty liver disease is more closely associated with CAC than abdominal obesity as assessed by the WHR. NAFLD could be considered an independent determinant of subclinical atherosclerosis as assessed by CAC.
authors.affiliation: Department of Endocrinology and Metabolism, Seonam University Myongji Hospital, Goyang, Korea. min7949@hanmail.net.
authors.forename: Min-Kyung
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. hj207.park@samsung.com.
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. ailin7899@naver.com.
authors.forename: Won Seon
authors.initials: WS
authors.lastname: Jeon
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. liplips@hanmail.net.
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. cyber.park@samsung.com.
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. drlwy@hanmail.net.
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. okwendo@naver.com.
authors.forename: Ki-Won
authors.initials: KW
authors.lastname: Oh
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. sungwoo0913.park@samsung.com.
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyungdong, Jongro-ku, Seoul, Korea. hongsiri@hanmail.net.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Rhee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology*; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D014463:Ultrasonography; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*; D049629:Waist-Hip Ratio; D055815:Young Adult