Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA.
Atherosclerosis. 2013 Oct;230(2):258-67. doi: 10.1016/j.atherosclerosis.2013.07.052. Epub 2013 Aug 9.
Non-alcoholic fatty liver disease (NAFLD) is an emerging disease and a leading cause of chronic liver disease. The prevalence in the general population is approximately 15-30% and it increases to 70-90% in obese or diabetic populations. NAFLD has been linked to increased cardiovascular disease (CVD) risk. It is therefore critical to evaluate the relationship between markers of subclinical CVD and NAFLD.
An extensive search of databases; including the National Library of Medicine and other relevant databases for research articles meeting inclusion criteria: observational or cohort, studies in adult populations and clearly defined NAFLD and markers of subclinical CVD.
Twenty-seven studies were included in the review; 16 (59%) presented the association of NAFLD and carotid intima-media thickness (CIMT), 7 (26%) the association with coronary calcification and 7 (26%) the effect on endothelial dysfunction and 6 (22%) influence on arterial stiffness. CIMT studies showed significant increases among NAFLD patients compared to controls. These were independent of traditional risk factors and metabolic syndrome. The association was similar in coronary calcification studies. The presence of NAFLD is associated with the severity of the calcification. Endothelial dysfunction and arterial stiffness showed significant independent associations with NAFLD. Two studies argued the associations were not significant; however, these studies were limited to diabetic populations.
There is evidence to support the association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome. However, there is need for future longitudinal studies to review this association to ascertain causality and include other ethnic populations.
非酒精性脂肪性肝病（NAFLD）是一种新兴疾病，也是慢性肝病的主要病因。普通人群的患病率约为 15-30%，而在肥胖或糖尿病患者中则增至 70-90%。NAFLD 与心血管疾病（CVD）风险增加有关。因此，评估亚临床 CVD 标志物与 NAFLD 之间的关系至关重要。
广泛检索数据库；包括国家医学图书馆和其他相关数据库，以查找符合纳入标准的研究文章：观察性或队列研究，研究对象为成年人群，且明确界定了 NAFLD 和亚临床 CVD 标志物。
共有 27 项研究纳入本综述；16 项（59%）研究表明 NAFLD 与颈动脉内膜中层厚度（CIMT）相关，7 项（26%）研究表明与冠状动脉钙化相关，7 项（26%）研究表明对内皮功能障碍有影响，6 项（22%）研究表明对动脉僵硬度有影响。与对照组相比，NAFLD 患者的 CIMT 显著增加。这些增加与传统危险因素和代谢综合征无关。在冠状动脉钙化研究中也存在类似的关联。NAFLD 的存在与钙化的严重程度有关。内皮功能障碍和动脉僵硬度与 NAFLD 存在显著的独立关联。有两项研究认为这些关联不显著；然而，这些研究仅限于糖尿病患者。
有证据支持 NAFLD 与亚临床动脉粥样硬化之间存在关联，这种关联独立于传统危险因素和代谢综合征。然而，需要进一步进行前瞻性纵向研究来审查这种关联，以确定因果关系并纳入其他种族人群。
