title: Association of Nonalcoholic Fatty Liver Disease With Visceral Adiposity but Not Coronary Artery Calcification in the Elderly.
abstract: Nonalcoholic fatty liver disease (NAFLD) is related closely to risk factors for coronary artery disease, but it is unclear whether NAFLD independently contributes to atherosclerosis. We investigated the association between NAFLD and coronary artery calcium (CAC) scores, determined based on noncontrast cardiac computed tomography data, in an elderly cohort.
  
  
  
  We conducted a longitudinal, cross-sectional study of data from 250 participants (mean age, 67.6 ± 7.0 y; 43.2% men) in the Rancho Bernardo Study-a prospective population-based study of mostly white adults in suburban Southern California. We compared CAC scores, liver-to-spleen attenuation ratio, and volumes of visceral adipose tissue (VAT) at baseline and after a 5-year follow-up period.
  
  
  
  We assigned participants to groups based on CAC scores (0, 0-10, 11-100, 101-400, and >400). Among groups, the liver-to-spleen attenuation ratio did not vary significantly, but VAT increased with CAC score (median and interquartile range values were as follows: 50.0 [33.3-77.4] cm(3), 63.0 [33.9-93.1] cm(3), 66.1 [48.2-80.2] cm(3), 69.1 [48.1-85.0] cm(3), 76.1 [53.1-108.5] cm(3) for CAC groups; P = .0054). In multivariable regression analysis, NAFLD at baseline was not associated with an increased risk of a CAC score greater than 0. Longitudinal analysis showed that visceral fat, but not hepatic steatosis, increased in participants with increasing CAC scores (interquartile range 57.1-92.4) vs 55.2 cm(3) in patients without (interquartile range 36.5-81.1, P = .0401). The proportion of patients with NAFLD decreased after the 5-year follow-up period (from 29.3% before to 14.1% afterward; P = .0081), despite increased mean CAC scores and VAT volume in patients.
  
  
  
  In adults age 67.6 ± 7.0 years, the proportion with NAFLD decreased despite increasing CAC score and VAT with age. There was no clear association between NAFLD and CAC score. However, VAT was associated with baseline and increasing CAC scores. Visceral adiposity therefore might be a risk factor for coronary artery disease.
authors.affiliation: Department of Radiology, University of California San Diego, La Jolla, California.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Jacobs
authors.affiliation: Department of Radiology, University of California San Diego, La Jolla, California.
authors.forename: Sharon
authors.initials: S
authors.lastname: Brouha
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Ricki
authors.initials: R
authors.lastname: Bettencourt
authors.affiliation: Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Department of Radiology, University of California San Diego, La Jolla, California.
authors.forename: Claude
authors.initials: C
authors.lastname: Sirlin
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California; NAFLD Translational Research Unit, University of California San Diego, La Jolla, California. Electronic address: roloomba@ucsd.edu.
authors.forename: Rohit
authors.initials: R
authors.lastname: Loomba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000032:analysis; D002140:California / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D002118:Calcium
keywords: Cardiac Computed Tomography; Coronary Artery Calcium; Coronary Artery Disease; Metabolic Syndrome