Department of Gastroenterology and Hepatology, Saint Luke's Hospital of Kansas City, Kansas City, MO; Liver Disease Management Center and Division of Gastroenterology, Department of Medicine, Saint Luke's Hospital, Kansas City, MO; School of Medicine, Department of Medicine, University of Missouri-Kansas City, Kansas City, MO.
Mayo Clin Proc. 2013 Nov;88(11):1259-65. doi: 10.1016/j.mayocp.2013.06.025. Epub 2013 Oct 16.
To determine the association of coronary artery calcification with hepatic steatosis in asymptomatic volunteers.
The study group comprised 400 asymptomatic volunteers, enrolled from April 1, 2011, to September 30, 2012, without known coronary artery disease who were self-referred for screening noncontrast computed tomography to determine coronary calcium score (CCS). Computed tomographic images were used to determine the presence of hepatic steatosis. An a priori model was created to predict a CCS of 100 Agatston units (AU) or higher on the basis of Framingham risk factors, diabetes mellitus, and metabolic syndrome. Hepatic steatosis was then added to this model. Computation of the odds ratio (OR) for hepatic steatosis predicting a CCS of 100 AU or higher was performed. Finally, the OR for a CCS of 100 AU or higher being associated with hepatic steatosis was calculated.
When hepatic steatosis was added to traditional coronary risk factors, it was independently associated with a CCS of 100 AU or higher (OR, 2.85). This was greater than the OR of Framingham factors, diabetes mellitus, or metabolic syndrome. A CCS of 100 AU or higher was independently associated with an increased risk for hepatic steatosis (OR, 2.4). This OR was higher than traditional hepatic steatosis risk factors or metabolic syndrome.
Hepatic steatosis is a strong independent predictor of a CCS of 100 AU or higher in asymptomatic patients. It is associated with an increased risk of coronary artery disease beyond that expected from traditional coronary risk factors and/or metabolic syndrome. Additional studies are needed to clarify the role of hepatic steatosis as a possible independent risk factor for the development of coronary artery disease.
确定无症状志愿者的冠状动脉钙化与肝脂肪变性之间的关联。
研究组包括 2011 年 4 月 1 日至 2012 年 9 月 30 日期间招募的 400 名无症状志愿者，这些志愿者自行进行非对比计算机断层扫描（CT）筛查以确定冠状动脉钙评分（CCS）。使用 CT 图像确定肝脂肪变性的存在。根据弗雷明汉危险因素、糖尿病和代谢综合征，建立了一个预测 CCS 为 100 个阿加斯顿单位（AU）或更高的模型。然后将肝脂肪变性添加到该模型中。计算肝脂肪变性预测 CCS 为 100 AU 或更高的优势比（OR）。最后，计算 CCS 为 100 AU 或更高与肝脂肪变性相关的 OR。
当将肝脂肪变性添加到传统的冠状动脉危险因素中时，它与 CCS 为 100 AU 或更高独立相关（OR，2.85）。这大于弗雷明汉因素、糖尿病或代谢综合征的 OR。CCS 为 100 AU 或更高与肝脂肪变性的风险增加独立相关（OR，2.4）。该 OR 高于传统的肝脂肪变性危险因素或代谢综合征。
肝脂肪变性是无症状患者 CCS 为 100 AU 或更高的强烈独立预测因素。它与冠状动脉疾病的风险增加有关，超过了传统的冠状动脉危险因素和/或代谢综合征的预期。需要进一步研究以阐明肝脂肪变性作为冠状动脉疾病发展的可能独立危险因素的作用。
