Lee Sun Hwa, Yun Seong Jong, Kim Dong Hyeon, Jo Hyeon Hwan, Park Yong Sung
Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Seoul, Nowon-gu, 139-707, Republic of Korea.
Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea.
J Clin Ultrasound. 2017 Sep;45(7):391-399. doi: 10.1002/jcu.22472. Epub 2017 Mar 28.
To evaluate the relationship between nonalcoholic fatty liver disease (NAFLD) on sonography (US) and the risk of coronary heart disease (CHD) as well as the predictive value of US-diagnosed NAFLD to determine intermediate/high CHD risk compared with as well as in combination on with NAFLD fibrosis score (NFS).
This retrospective study included 1,276 patients examined between November 2015 and August 2016. NAFLD was categorized as absent, mild, moderate, or severe based on liver-to-kidney echogenicity, visibility of intrahepatic vessel walls, and the diaphragm. The Framingham risk score (FRS) and NFS were used to predict CHD risk and hepatic fibrosis severity. Spearman correlation test, multivariate-adjusted logistic regression analysis, and receiver operating characteristic curves were used for statistical evaluation.
FRS increased as NAFLD severity increased, and US-determined NAFLD severity and FRS were highly positively correlated (r = 0.683, p < 0.001). The odds ratios for intermediate/high CHD risk increased with increasing NAFLD severity. The predictive performance of US-determined NAFLD severity for determining intermediate/high CHD risk in NAFLD patients was 0.738. There was no significant difference between US-determined NAFLD severity and NFS in terms of identifying intermediate/high CHD risk (p = 0.88). However, the combination of US-determined NAFLD severity and NFS significantly improved the ability to distinguish intermediate/high CHD risk compared with that of US-determined NAFLD severity or NFS alone (p < 0.001 for both).
US-determined NAFLD severity was well correlated with FRS and associated with the prevalence of intermediate/high CHD risk. The combination of US-determined NAFLD severity and NFS may be useful for predicting CHD risk. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:391-399, 2017.
评估超声检查（US）诊断的非酒精性脂肪性肝病（NAFLD）与冠心病（CHD）风险之间的关系，以及US诊断的NAFLD对于确定中度/高度CHD风险的预测价值，并与NAFLD纤维化评分（NFS）进行比较以及联合使用。
这项回顾性研究纳入了2015年11月至2016年8月期间接受检查的1276例患者。根据肝肾回声、肝内血管壁的可见性和膈肌情况，将NAFLD分为无、轻度、中度或重度。采用弗明汉风险评分（FRS）和NFS来预测CHD风险和肝纤维化严重程度。使用Spearman相关性检验、多变量调整逻辑回归分析和受试者工作特征曲线进行统计评估。
随着NAFLD严重程度增加，FRS升高，且US确定的NAFLD严重程度与FRS高度正相关（r = 0.683，p < 0.001）。中度/高度CHD风险的比值比随NAFLD严重程度增加而升高。US确定的NAFLD严重程度对NAFLD患者中度/高度CHD风险的预测性能为0.738。在识别中度/高度CHD风险方面，US确定的NAFLD严重程度与NFS之间无显著差异（p = 0.88）。然而，与单独使用US确定的NAFLD严重程度或NFS相比，US确定的NAFLD严重程度与NFS联合使用显著提高了区分中度/高度CHD风险的能力（两者均p < 0.001）。
US确定的NAFLD严重程度与FRS密切相关，并与中度/高度CHD风险的患病率相关。US确定的NAFLD严重程度与NFS联合使用可能有助于预测CHD风险。© 2017威利期刊公司。《临床超声杂志》2017年第45卷：391 - 399页。
