You Seng Chan, Kim Kwang Joon, Kim Seung Up, Kim Beom Kyung, Park Jun Yong, Kim Do Young, Ahn Sang Hoon, Han Kwang-Hyub
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Severance Executive Healthcare Clinic, Yonsei University Health System, Seoul, Korea.
J Gastroenterol Hepatol. 2015 Oct;30(10):1536-42. doi: 10.1111/jgh.12992.
Non-alcoholic fatty liver disease (NAFLD) has a close relationship with coronary atherosclerosis. We investigated the association between coronary atherosclerosis and liver fibrosis, represented as coronary artery calcification (CAC) score, and live stiffness (LS) value assessed using transient elastography (TE), respectively, in patients with NAFLD.
Between January 2013 and March 2014, a total of 285 asymptomatic subjects without chronic liver and ischemic heart diseases who underwent comprehensive medical health check-up were recruited. NAFLD was defined as controlled attenuation parameter (CAP) ≥ 250 dB/m on TE.
The median age of the study population (men 161 and women 124) was 56 (interquartile [IQR], 50-63) years. Of these, 142 (49.8%) subjects had NAFLD. Among subjects with NAFLD, CAC score was independently correlated with the male gender (β = 0.230; P = 0.010), elevated erythrocyte sedimentation rate (β = 0.220; P = 0.019), reduced estimated glomerular filtration rate (β=-0.220; P = 0.004), increased left ventricular mass index (β = 0.226; P = 0.027), and higher LS values (β = 0.274; P < 0.001). In addition, alanine aminotransferase level (β = 0.214, P = 0.012) and CAC score (β = 0.311; P = 0.001) are the only independent factors associated with LS values in subjects with NAFLD.
Higher CAC score was independently correlated with LS values in subjects with NAFLD. However, it should be further investigated whether TE can be incorporated into a screening tool to identify the high-risk population for coronary artery disease.
非酒精性脂肪性肝病（NAFLD）与冠状动脉粥样硬化密切相关。我们分别研究了NAFLD患者中冠状动脉粥样硬化与肝纤维化之间的关联，其中冠状动脉粥样硬化以冠状动脉钙化（CAC）评分表示，肝硬度（LS）值通过瞬时弹性成像（TE）评估。
在2013年1月至2014年3月期间，共招募了285名无慢性肝病和缺血性心脏病的无症状受试者，他们接受了全面的健康体检。NAFLD定义为TE上的控制衰减参数（CAP）≥250 dB/m。
研究人群（男性161名，女性124名）的中位年龄为56岁（四分位间距[IQR]，50 - 63岁）。其中，142名（49.8%）受试者患有NAFLD。在患有NAFLD的受试者中，CAC评分与男性性别（β = 0.230；P = 0.010）、红细胞沉降率升高（β = 0.220；P = 0.019）、估计肾小球滤过率降低（β = -0.220；P = 0.004）、左心室质量指数增加（β = 0.226；P = 0.027）以及更高的LS值（β = 0.274；P < 0.001）独立相关。此外，丙氨酸氨基转移酶水平（β = 0.214，P = 0.012）和CAC评分（β = 0.311；P = 0.001）是与NAFLD受试者LS值相关的仅有的独立因素。
在NAFLD受试者中，较高的CAC评分与LS值独立相关。然而，TE是否可纳入筛查工具以识别冠心病高危人群仍需进一步研究。
