title: Severity of nonalcoholic fatty liver disease on sonography and risk of coronary heart disease.
abstract: OBJECTIVE
  To evaluate the relationship between nonalcoholic fatty liver disease (NAFLD) on sonography (US) and the risk of coronary heart disease (CHD) as well as the predictive value of US-diagnosed NAFLD to determine intermediate/high CHD risk compared with as well as in combination on with NAFLD fibrosis score (NFS).
  
  
  METHODS
  This retrospective study included 1,276 patients examined between November 2015 and August 2016. NAFLD was categorized as absent, mild, moderate, or severe based on liver-to-kidney echogenicity, visibility of intrahepatic vessel walls, and the diaphragm. The Framingham risk score (FRS) and NFS were used to predict CHD risk and hepatic fibrosis severity. Spearman correlation test, multivariate-adjusted logistic regression analysis, and receiver operating characteristic curves were used for statistical evaluation.
  
  
  RESULTS
  FRS increased as NAFLD severity increased, and US-determined NAFLD severity and FRS were highly positively correlated (r = 0.683, p < 0.001). The odds ratios for intermediate/high CHD risk increased with increasing NAFLD severity. The predictive performance of US-determined NAFLD severity for determining intermediate/high CHD risk in NAFLD patients was 0.738. There was no significant difference between US-determined NAFLD severity and NFS in terms of identifying intermediate/high CHD risk (p = 0.88). However, the combination of US-determined NAFLD severity and NFS significantly improved the ability to distinguish intermediate/high CHD risk compared with that of US-determined NAFLD severity or NFS alone (p < 0.001 for both).
  
  
  CONCLUSIONS
  US-determined NAFLD severity was well correlated with FRS and associated with the prevalence of intermediate/high CHD risk. The combination of US-determined NAFLD severity and NFS may be useful for predicting CHD risk. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:391-399, 2017.
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Seoul, Nowon-gu, 139-707, Republic of Korea.
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea.
authors.forename: Seong Jong
authors.identifier: http://orcid.org/0000-0002-3775-5701
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea.
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea.
authors.forename: Hyeon Hwan
authors.initials: HH
authors.lastname: Jo
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, Republic of Korea.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Park
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods*
keywords: Framingham risk score; coronary heart disease risk; liver fibrosis; nonalcoholic fatty liver disease; ultrasonography