Koulaouzidis George, Charisopoulou Dafni, Kukla Michał, Marlicz Wojciech, Rydzewska Grażyna, Koulaouzidis Anastasios, Skonieczna-Żydecka Karolina
Department of Biochemical Sciences, Pomeranian Medical University, Szczecin, Poland.
Amalia Children's Hospital, Radboud University Medical Centre, Nijmegen, Netherlands.
Prz Gastroenterol. 2021;16(3):196-206. doi: 10.5114/pg.2021.109063. Epub 2021 Sep 17.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, which is estimated to affect 20-30% of the adult population in Europe. Several studies have shown an association of NAFLD with multiple cardiovascular risk factors such as abdominal obesity, atherogenic dyslipidaemia, hypertension, insulin resistance, and impaired glucose tolerance. Atherosclerosis is a chronic, progressive, inflammatory disease, which begins early in life and follows a long asymptomatic phase. Coronary artery calcification (CAC) is the radiological confirmation of the presence of atherosclerotic coronary artery disease. The predictive value of CAC for future cardiac events is well established. Also, the progression of CAC is strongly associated with the development of cardiovascular events.
To assess the association of NAFLD with the progression of subclinical atherosclerotic activity, reflected as the dynamic changes in CAC score over time.
The databases PubMed/Medline/Embase from inception until 31 December 2020 were searched for observational studies investigating NAFLD and CAC progression in adults.
In total, 5 studies were included, 4 of which, including 10,060 patients, provided data regarding the association of NAFLD with the progression of CAC. The analysis showed that NAFLD is associated with significant odds of progression of CAC; OR = 1.5, 95% CI: 1.34-1.68, = 0.001. No publication bias was detected (Egger's test = 0.6). Meta-regression analyses proved that OR toward CAC progression is not significantly influenced by the time of follow-up (coefficient = 0.0083, = 1.14, = 0.25).
NAFLD increases the risk toward CAC progression over time.
非酒精性脂肪性肝病（NAFLD）是最常见的慢性肝病，据估计在欧洲影响20% - 30%的成年人口。多项研究表明，NAFLD与多种心血管危险因素相关，如腹型肥胖、致动脉粥样硬化性血脂异常、高血压、胰岛素抵抗和糖耐量受损。动脉粥样硬化是一种慢性、进行性、炎症性疾病，在生命早期开始，并经历漫长的无症状期。冠状动脉钙化（CAC）是动脉粥样硬化性冠状动脉疾病存在的影像学证实。CAC对未来心脏事件的预测价值已得到充分证实。此外，CAC的进展与心血管事件的发生密切相关。
评估NAFLD与亚临床动脉粥样硬化活动进展的关联，以CAC评分随时间的动态变化来反映。
检索了从数据库建立至2020年12月31日的PubMed/Medline/Embase数据库，以查找关于成人NAFLD和CAC进展的观察性研究。
共纳入5项研究，其中4项研究（包括10,060名患者）提供了关于NAFLD与CAC进展关联的数据。分析表明，NAFLD与CAC进展的显著几率相关；OR = 1.5，95%CI：1.34 - 1.68，P = 0.001。未检测到发表偏倚（Egger检验P = 0.6）。Meta回归分析证明，随访时间对CAC进展的OR没有显著影响（系数 = 0.0083，P = 1.14，P = 0.25）。
随着时间的推移，NAFLD增加了CAC进展的风险。
