Jeong Joonho, Han Seungbong, Park Gyung-Min, Park Sangwoo, Jeon Young-Jee, Lim Soyeoun, Kwon Woon Jung, Choi Seong Hoon, Park Neung Hwa
Division of Hepatology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Biostatistics, College of Medicine, Korea University, Goryeodae-ro 73, Anam-dong, Seongbuk-gu, Seoul, 02841, Republic of Korea.
Sci Rep. 2025 Jul 10;15(1):24953. doi: 10.1038/s41598-025-10380-9.
Previous population-based studies have demonstrated differences in cardiovascular events according to the new classification of steatotic liver disease (SLD). However, detailed data on coronary artery status have not been presented. We aimed to investigate the association between subtypes of SLD and coronary artery status using findings from coronary computed tomography angiography (CCTA). We analyzed 8622 asymptomatic individuals without coronary artery disease (CAD) who underwent both abdominal ultrasonography and CCTA. Study participants were divided into four groups: 934 in the no SLD without cardiometabolic (CM) criteria group, 4811 in the no SLD with CM criteria group, 2494 in the metabolic dysfunction-associated steatotic liver disease (MASLD) group, and 252 in the MASLD with increased alcohol intake (Met-ALD) group. Obstructive CAD was defined as coronary arterial stenosis ≥ 50%. Compared with the no SLD without CM group, the no SLD with CM, MASLD, and Met-ALD groups were significantly associated with any coronary plaque (multivariable-adjusted OR 2.05 [95% CI 1.67-2.52], 2.71 [2.18-3.35], and 2.36 [1.69-3.31], respectively); calcified plaques (1.97 [1.59-2.43], 2.54 [2.04-3.16], and 2.10 [1.49-2.96], respectively); non-calcified plaques (2.04 [1.28-3.25], 2.42 [1.51-3.89], and 3.26 [1.73-6.13], respectively); and obstructive CAD (2.57 [1.53-4.32], 3.64 [2.15-6.16], and 3.51 [1.73-7.10], respectively) (p for all < 0.05). In addition, the inverse probability of treatment weighting (IPTW) analyses showed similar ORs for coronary plaques and obstructive CAD. Additionally, higher steatosis-associated fibrosis estimator (SAFE) was strongly associated with all atherosclerotic plaques and obstructive CAD. This association remained significant after multivariable adjustment and IPTW analyses. Subtypes of SLD had significant, yet different strengths of associations with subclinical coronary atherosclerosis. SAFE score classification effectively stratified the distinct associations with subclinical atherosclerosis in subjects with MASLD.
以往基于人群的研究表明，根据脂肪性肝病（SLD）的新分类，心血管事件存在差异。然而，尚未提供有关冠状动脉状况的详细数据。我们旨在利用冠状动脉计算机断层扫描血管造影（CCTA）的结果，研究SLD亚型与冠状动脉状况之间的关联。我们分析了8622名无症状且无冠状动脉疾病（CAD）的个体，这些个体同时接受了腹部超声检查和CCTA。研究参与者被分为四组：无SLD且无心脏代谢（CM）标准组934人，无SLD且有CM标准组4811人，代谢功能障碍相关脂肪性肝病（MASLD）组2494人，以及饮酒量增加的MASLD（Met-ALD）组252人。阻塞性CAD定义为冠状动脉狭窄≥50%。与无SLD且无CM组相比，无SLD且有CM组、MASLD组和Met-ALD组与任何冠状动脉斑块（多变量调整后的OR分别为2.05 [95%CI 1.67 - 2.52]、2.71 [2.18 - 3.35]和2.36 [1.69 - 3.31]）、钙化斑块（分别为1.97 [1.59 - 2.43]、2.54 [2.04 - 3.16]和2.10 [1.49 - 2.96]）、非钙化斑块（分别为2.04 [1.28 - 3.25]、2.42 [1.5
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