Alcoholic and non-alcoholic fatty liver disease and associations with coronary artery calcification: evidence from the Kangbuk Samsung Health Study
Alcoholic and non-alcoholic fatty liver disease and associations with coronary artery calcification: evidence from the Kangbuk Samsung Health Study
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DOI：
10.1136/gutjnl-2018-317666
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发表时间：
2019-09-01
期刊：
影响因子：
24.5
通讯作者：
Byrne, Christopher D.
中科院分区：
文献类型：
--
作者：
Chang, Yoosoo;Ryu, Seungho;Byrne, Christopher D.
目的最近的证据表明，酒精性脂肪性肝病(AFLD)和非酒精性脂肪性肝病(NAFLD)对心血管死亡的风险可能存在差异。为了研究AFLD和NAFLD对早期冠状动脉粥样硬化风险的影响是否相似或不同，我们调查了AFLD和NAFLD与冠状动脉钙(CAC)的关系。设计对105 328名参加健康体检的韩国成年人进行横断面研究。用CT评估CAC评分，每日饮酒量以克/天为单位，肝脏脂肪用超声进行记录。结果NAFLD和AFLD均与CAC评分呈正相关。在调整了潜在的混杂因素后，NAFLD和AFLD与参考值(既没有酗酒也没有脂肪肝)相比，CAC和AFLD的多变量调整OR(95%CI)分别为1.10(95%CI为1.05~1.16)和1.20(95%CI为1.11~1.30)。在后组分析中，AFLD与NAFLD相比，可检CAC的OR(95%CI)为1.09(95%CI为1.01~1.17)。在非肥胖者和肥胖者中，非肥胖者和肥胖者的非肥胖性脂肪肝和非肥胖性脂肪肝与CAC得分的相关性相似(交互作用p=0.088)。在调整胰岛素抵抗和高敏C反应蛋白的稳态模型评估后，脂肪肝疾病与CAC评分之间的相关性仍然具有统计学意义。结论在这一大样本中青年个体中，NAFLD和AFLD引起的早期肝病都与冠状动脉钙化显著相关。
Objective Recent evidence suggests that alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD) may differentially affect risk of cardiovascular mortality. To investigate whether early liver disease due to AFLD or NAFLD have similar or dissimilar effects on risk of early coronary artery atherosclerosis, we have investigated the associations between AFLD and NAFLD and coronary artery calcium (CAC).Design A cross-sectional study was performed in 105 328 Korean adults who attended a health check-up programme. CAC score was assessed using CT, daily alcohol intake was recorded as grams/day and liver fat by ultrasound. Logistic regression model was used to calculate ORs with 95% CIs for prevalent CAC.Results Both NAFLD and AFLD were positively associated with CAC score. After adjusting for potential confounders, multivariable-adjusted OR (95% CIs) for CAC > 0 comparing NAFLD and AFLD to the reference (absence of both excessive alcohol use and fatty liver disease) were 1.10 (95% CI 1.05 to 1.16) and 1.20 (95% CI 1.11 to 1.30), respectively. In post hoc analysis, OR (95%CI) for detectable CAC comparing AFLD to NAFLD was 1.09 (95% CI 1.01 to 1.17). Associations of NAFLD and AFLD with CAC scores were similar in both non-obese and obese individuals without significant interaction by obesity (p for interaction=0.088). After adjusting for homeostasis model assessment of insulin resistance and high-sensitivity C reactive protein, the associations between fatty liver disease and CAC scores remained statistically significant.Conclusion In this large sample of young and middle-aged individuals, early liver disease due to NAFLD and AFLD were both significantly associated with the presence of coronary artery calcification.