Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pio XII, 36, 31008, Pamplona, Spain.
Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain.
Sci Rep. 2022 Apr 21;12(1):6564. doi: 10.1038/s41598-022-10487-3.
Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease morbimortality. However, it is not clear if NAFLD staging may help identify early or subclinical markers of cardiovascular disease. We aimed to evaluate the association of liver stiffness and serum markers of liver fibrosis with epicardial adipose tissue (EAT) and coronary artery calcium (CAC) in an observational cross-sectional study of 49 NAFLD patients that were seen at Clínica Universidad de Navarra (Spain) between 2009 and 2019. Liver elastography and non-invasive fibrosis markers were used to non-invasively measure fibrosis. EAT and CAC, measured through visual assessment, were determined by computed tomography. Liver stiffness showed a direct association with EAT (r = 0.283, p-value = 0.049) and CAC (r = 0.337, p-value = 0.018). NAFLD fibrosis score was associated with EAT (r = 0.329, p-value = 0.021) and CAC (r = 0.387, p-value = 0.006). The association of liver stiffness with CAC remained significant after adjusting for metabolic syndrome features (including carbohydrate intolerance/diabetes, hypertension, dyslipidaemia, visceral adipose tissue, and obesity). The evaluation of NAFLD severity through liver elastography or non-invasive liver fibrosis biomarkers may contribute to guide risk factor modification to reduce cardiovascular risk in asymptomatic patients. Inversely, subclinical cardiovascular disease assessment, through Visual Scale for CAC scoring, may be a simple and effective measure for patients with potential liver fibrosis, independently of the existence of other cardiovascular risk factors.
非酒精性脂肪性肝病（NAFLD）与心血管疾病的发病率和死亡率相关。然而，目前尚不清楚 NAFLD 分期是否有助于发现心血管疾病的早期或亚临床标志物。我们旨在评估肝脏硬度和血清肝纤维化标志物与心外膜脂肪组织（EAT）和冠状动脉钙（CAC）在观察性、横断面研究中的相关性，该研究纳入了 2009 年至 2019 年期间在纳瓦拉大学临床医院就诊的 49 例 NAFLD 患者。肝脏弹性成像和非侵入性纤维化标志物用于无创性测量纤维化。EAT 和 CAC 通过视觉评估，通过计算机断层扫描确定。肝脏硬度与 EAT（r=0.283，p 值=0.049）和 CAC（r=0.337，p 值=0.018）呈直接相关。NAFLD 纤维化评分与 EAT（r=0.329，p 值=0.021）和 CAC（r=0.387，p 值=0.006）相关。在调整代谢综合征特征（包括碳水化合物不耐受/糖尿病、高血压、血脂异常、内脏脂肪组织和肥胖）后，肝脏硬度与 CAC 的相关性仍然显著。通过肝脏弹性成像或非侵入性肝纤维化生物标志物评估 NAFLD 严重程度可能有助于指导危险因素的改变，以降低无症状患者的心血管风险。相反，通过 CAC 评分视觉量表进行亚临床心血管疾病评估可能是一种简单有效的措施，适用于有潜在肝纤维化的患者，独立于其他心血管危险因素的存在。
