Friedrich-Rust Mireen, Schoelzel Fabian, Maier Sebastian, Seeger Florian, Rey Julia, Fichtlscherer Stephan, Herrmann Eva, Zeuzem Stefan, Bojunga Joerg
Department of Internal Medicine 1, Hospital of the Goethe University, Frankfurt, Germany.
Department of Internal Medicine 3, Hospital of the Goethe University, Frankfurt, Germany.
PLoS One. 2017 Oct 26;12(10):e0186720. doi: 10.1371/journal.pone.0186720. eCollection 2017.
Liver steatosis has shown to be associated with coronary artery disease (CAD). The aim of our study was to evaluate the association between the presence and severity of CAD and Non-alcoholic fatty liver disease (NAFLD) assessed by transient elastography (TE) and controlled attenuation parameter (CAP).
576 Patients undergoing coronary angiography were enrolled in this prospective study, receiving at least 10 TE and CAP measurements using the FibroScan® M-probe. Clinically relevant CAD (CAD 3) was defined as stenosis with ≥75% reduction of the luminal diameter. NAFLD was determined by CAP ≥234 dB/m. NAFLD with advanced fibrosiswas determined by TE-values ≥7.9kPa in the presence of NAFLD and absence of congestive or right-sided heart failure. Rates and 95% confidence intervals are shown.
505 patients were available for analysis of NAFLD. However, only 392 patients were available for analysis of NAFLD with advanced fibrosis, since 24 patients had to be excluded due to non valid TE-measurements and 89 patients due to congestive or right-sided heart failure or suspected concomitant liver disease, respectively. 70.5% (66.3%-74.4%) of patients had CAD 3, 71.5% (67.3%-75.4%) were diagnosed with NAFLD, and 11.2% (8.3%-14.8%) with NAFLD with advanced fibrosis. Patients with CAD 3 had higher median CAP-values (273±61 vs. 260±66 dB/m; p = 0.038) and higher degrees of steatosis as compared to patients without CAD 3. While NAFLD was significantly more often diagnosed in patients with CAD 3 (75.0% vs. 63.1%, p = 0.0068), no significant difference was found for NAFLD with advanced fibrosis (10.7% vs. 12.5%, p = 0.60).
Clinically relevant CAD is frequently associated with the presence of NAFLD, but not NAFLD with advanced fibrosis.
肝脂肪变性已被证明与冠状动脉疾病（CAD）相关。本研究的目的是评估通过瞬时弹性成像（TE）和受控衰减参数（CAP）评估的CAD的存在和严重程度与非酒精性脂肪性肝病（NAFLD）之间的关联。
576例接受冠状动脉造影的患者纳入了这项前瞻性研究，使用FibroScan® M探头至少进行10次TE和CAP测量。临床相关CAD（CAD 3）定义为管腔直径减少≥75%的狭窄。NAFLD由CAP≥234 dB/m确定。存在NAFLD且无充血性或右侧心力衰竭时，NAFLD合并晚期纤维化由TE值≥7.9kPa确定。显示了发生率和95%置信区间。
505例患者可用于NAFLD分析。然而，只有392例患者可用于NAFLD合并晚期纤维化分析，因为分别有24例患者因TE测量无效、89例患者因充血性或右侧心力衰竭或疑似合并肝病而被排除。70.5%（66.3%-74.4%）的患者患有CAD 3，71.5%（67.3%-75.4%）被诊断为NAFLD，11.2%（8.3%-14.8%）为NAFLD合并晚期纤维化。与无CAD 3的患者相比，CAD 3患者的CAP中位数更高（273±61 vs. 260±66 dB/m；p = 0.038），脂肪变性程度更高。虽然CAD 3患者中NAFLD的诊断明显更常见（75.0% vs. 63.1%，p = 0.0068），但NAFLD合并晚期纤维化患者之间未发现显著差异（10.7% vs. 12.5%，p = 0.60）。
临床相关CAD常与NAFLD的存在相关，但与NAFLD合并晚期纤维化无关。
