Jackson Heart Study, University of Mississippi Medical Center, 350 W Woodrow Wilson Dr, Jackson State University, Jackson, MS 39213-4505, USA.
Atherosclerosis. 2012 Oct;224(2):521-5. doi: 10.1016/j.atherosclerosis.2012.07.042. Epub 2012 Aug 10.
Both fatty liver and abdominal visceral fat (VAT) are associated with cardiometabolic risk factors. Whether fatty liver and VAT are jointly associated with coronary artery (CAC) or abdominal aortic (AAC) calcification is not clear.
Jackson Heart Study (JHS) participants (n = 2884, mean age 60 years, 65% women) underwent non-contrast CT Exam for assessment of fatty liver, VAT, and CAC and AAC. Fatty liver was measured by liver attenuation (LA; low LA = high fatty liver). The Agatston score was used to quantify the amount of calcified artery plaque and the presence of calcified artery plaque was defined as Agatston score>0. Cross-sectional associations of LA and VAT with CAC and AAC were examined in logistic regression models.
LA (per 1-standard deviation [SD] decrement) was associated inversely with CAC in age-sex-adjusted (OR 0.84, 95%CI 0.7-0.9, p = 0.0001) and multivariable-adjusted models (OR 0.89, 95%CI 0.8-0.9, p = 0.01). The association persisted for LA with CAC when additionally adjusted for body mass index (BMI) (OR 0.89, 95%CI 0.8-0.9, p = 0.03) or VAT (OR 0.90, 95%CI 0.8-0.9, p = 0.04). Abdominal VAT (per 1-SD increment) was positively associated with CAC in age-sex-adjusted models (OR 1.27, 95%CI 1.2-1.4, p = 0.0001), but the association was diminished with multivariable adjustment (OR 1.10, 95%CI 0.9-1.2, p = 0.09) and with additional adjustment for LA (p = 0.24) or BMI (p = 0.33). For AAC, the associations with LA and VAT were only present in age-sex-adjusted models. Finally, we did not observe interactions between LA and VAT for CAC (p = 0.18) or AAC (p = 0.24).
Fatty liver is associated with coronary atherosclerotic calcification independent of abdominal VAT or BMI in African Americans. Further investigations to uncover the clinical implications of fatty liver on coronary atherosclerosis in obesity are warranted.
脂肪肝和腹部内脏脂肪（VAT）均与心血管代谢危险因素相关。脂肪肝和 VAT 是否与冠状动脉（CAC）或腹主动脉（AAC）钙化有关尚不清楚。
杰克逊心脏研究（JHS）参与者（n=2884，平均年龄 60 岁，65%为女性）接受非对比 CT 检查，以评估脂肪肝、VAT 和 CAC 和 AAC。通过肝脏衰减（LA；低 LA=高脂肪肝）来测量脂肪肝。Agatston 评分用于量化钙化动脉斑块的数量，存在钙化动脉斑块定义为 Agatston 评分>0。在 logistic 回归模型中，检查 LA 和 VAT 与 CAC 和 AAC 的横断面关联。
在年龄性别调整（OR 0.84，95%CI 0.7-0.9，p=0.0001）和多变量调整模型（OR 0.89，95%CI 0.8-0.9，p=0.01）中，LA（每 1 个标准差[SD]递减）与 CAC 呈负相关。当进一步调整体重指数（BMI）（OR 0.89，95%CI 0.8-0.9，p=0.03）或 VAT（OR 0.90，95%CI 0.8-0.9，p=0.04）时，LA 与 CAC 的关联仍然存在。腹部 VAT（每 1 个 SD 增加）在年龄性别调整模型中与 CAC 呈正相关（OR 1.27，95%CI 1.2-1.4，p=0.0001），但多变量调整后相关性减弱（OR 1.10，95%CI 0.9-1.2，p=0.09），LA 或 BMI 进一步调整后（p=0.24）相关性减弱（p=0.33）。对于 AAC，LA 和 VAT 与 AAC 的关联仅存在于年龄性别调整模型中。最后，我们没有观察到 LA 和 VAT 之间对 CAC（p=0.18）或 AAC（p=0.24）的相互作用。
在非裔美国人中，脂肪肝与腹部 VAT 或 BMI 无关，与冠状动脉粥样硬化钙化有关。需要进一步研究以揭示肥胖症中脂肪肝对冠状动脉粥样硬化的临床意义。
