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Dig Liver Dis. 2016 Dec;48(12):1410-1417. doi: 10.1016/j.dld.2016.09.002. Epub 2016 Sep 17.

Nonalcoholic fatty liver disease is associated with coronary artery calcification: A systematic review and meta-analysis.

Author information

  • 1Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA; Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Electronic address: veeravich_j@hotmail.com.
  • 2Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA. Electronic address: kamonac120@gmail.com.
  • 3Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: anawin.sanguankeo@bassett.org.
  • 4Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: sikarin.upala@bassett.org.

Abstract

BACKGROUND:

Nonalcoholic fatty liver disease (NAFLD) is associated increased cardiovascular events and mortality. Coronary artery calcium scanning (CAC) is the robust predictor of coronary events in the asymptomatic individuals. Several recent studies have investigated the association between NAFLD and this surrogate marker. Thus, we conducted a systematic review and meta-analysis to better characterize the association between NAFLD and CAC.

METHODS:

MEDLINE and EMBASE were searched through May 2016. Primary outcome was the association between NAFLD and CAC. Pooled odds ratio (OR) and 95% confidence interval (CI) from multivariable-adjusted estimates were calculated using a random-effects model. The between-study heterogeneity of effect-size was quantified using the Q statistic and I2.

RESULTS:

Data were extracted from 16 studies (all cross-sectional studies) involving 16,433 NAFLD patients and 41,717 controls. NAFLD is significantly associated with CAC score >0 and CAC score >100 with pooled OR of 1.41 (95%CI 1.26-1.57, Pheterogeneity=0.07, I2=66%) and 1.24 (95%CI 1.02-1.52, Pheterogeneity=0.10, I2=42%).

CONCLUSIONS:

NAFLD is associated with increased coronary artery calcification independent of traditional risk factors. The assessment of coronary artery calcium may be useful in identifying NAFLD patients at risk of future cardiovascular events.

KEYWORDS:

Coronary artery disease; Coronary calcification; Coronary calcium; Meta-analysis; Nonalcoholic fatty liver disease

PMID:
27697419
DOI:
10.1016/j.dld.2016.09.002
[PubMed - in process]

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