Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans.
Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans.
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DOI：
10.1016/j.amjcard.2017.03.010
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发表时间：
2017-06-01
期刊：
影响因子：
--
通讯作者：
Laing ST
中科院分区：
文献类型：
--
作者：
Gill C;Vatcheva KP;Pan JJ;Smulevitz B;McPherson DD;Fallon M;McCormick JB;Fisher-Hoch SP;Laing ST
非酒精性脂肪性肝病（NAFLD）被认为是代谢综合征的肝脏表现，其标准是动脉粥样硬化性心血管疾病的危险因素。我们的目的是评估NAFLD的患病率，其与亚临床动脉粥样硬化的关系，以及可能解释墨西哥裔美国人这种关系的因素。在德克萨斯州卡梅隆县西班牙裔队列的基于人群的横断面样本中，测量了颈动脉内膜中层厚度（cIMT），这是亚临床动脉粥样硬化的指标。颈动脉超声检查异常定义为年龄、性别和/或斑块存在的平均cIMT >第75百分位数。在没有其他肝脏疾病原因的情况下，超声将NAFLD定义为脂肪变性。进行多变量加权回归分析，以评估NAFLD和cIMT之间的关联。平均年龄为50.4±1.2岁，58.3%为女性。平均体重指数（BMI）为31.0 ± 0.4 kg/m2，54.0%患有代谢综合征。NAFLD的患病率很高（48.80%）; NAFLD受试者的BMI、向心性肥胖、空腹血糖水平和血脂异常更高，更容易患代谢综合征。近三分之一的NAFLD受试者也有亚临床动脉粥样硬化的证据（31.2%）。在调整协变量后，NAFLD和cIMT增加之间仅在<45岁的年轻受试者中存在独立关联（p=0.0328）。肝脏和颈动脉超声检查均异常的受试者倾向于肥胖、糖尿病和代谢综合征。总之，NAFLD在这个墨西哥裔美国人队列中非常普遍，在年轻受试者中NAFLD和亚临床动脉粥样硬化之间存在独立关联;在这个健康差异队列中，糖尿病、肥胖和代谢综合征的聚集增加了年轻人肝脏疾病和早期动脉粥样硬化的风险。
Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT >75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4±1.2 years with 58.3% females. Mean body mass index (BMI) was 31.0 ± 0.4 kg/m2, and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater BMI, central obesity, fasting glucose levels, and dyslipidemia, and were more likely to have the metabolic syndrome. Nearly one third of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects <45 years (p=0.0328). Subjects with both abnormal liver and carotid ultrasound studies tended to be obese, diabetic, and have the metabolic syndrome. In conclusion, NAFLD is highly prevalent in this Mexican American cohort, with an independent association between NAFLD and subclinical atherosclerosis among younger subjects; clustering of diabetes, obesity, and metabolic syndrome in this health disparity cohort increases the risk of both liver disease and early atherosclerosis in young adults.
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