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World J Gastroenterol. Mar 14, 2007; 13(10): 1579-1584
Published online Mar 14, 2007. doi: 10.3748/wjg.v13.i10.1579
Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease
Masahide Hamaguchi, Takao Kojima, Noriyuki Takeda, Chisato Nagata, Jun Takeda, Hiroshi Sarui, Yutaka Kawahito, Naohisa Yoshida, Atsushi Suetsugu, Takahiro Kato, Junichi Okuda, Kazunori Ida, Toshikazu Yoshikawa
Masahide Hamaguchi, Yutaka Kawahito, Toshikazu Yoshikawa, Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
Takao Kojima, Naohisa Yoshida, Atsushi Suetsugu, Takahiro Kato, Junichi Okuda, Kazunori Ida, Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, Japan
Noriyuki Takeda, Hiroshi Sarui, Department of Endocrinology and Metabolism, Murakami Memorial Hospital, Asahi University, Japan
Chisato Nagata, Department of Epidemiology & Preventive Medicine, Graduate School of Medicine, Gifu University, Japan
Jun Takeda, Department of Diabetes and Endocrinology, Division of Molecule and Structure, Graduate School of Medicine, Gifu University, Japan
Author contributions: All authors contributed equally to the work.
Supported by a grant from the Gifu Medical Association
Correspondence to: Masahide Hamaguchi MD, Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. seele@mbox.kyoto-inet.or.jp
Telephone: +81-75-2515505 Fax: +81-75-2523721
Received: November 16, 2006
Revised: December 27, 2006
Accepted: January 20, 2007
Published online: March 14, 2007
Abstract

AIM: To clarify whether nonalcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular disease.

METHODS: We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program. NAFLD was diagnosed by abdominal ultrasonography. The metabolic syndrome (MS) was defined according to the modified National Cholesterol Education Program (NCEP) ATP III criteria. Five years after the baseline evaluations, the incidence of cardiovascular disease was assessed by a self-administered questionnaire.

RESULTS: Among 1221 participants available for outcome analyses, the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline (5 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage) than 990 subjects without NAFLD (3 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage). Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors (odds ratio 4.12, 95% CI, 1.58 to 10.75, P = 0.004). MS was also independently associated with cardiovascular events. But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.

CONCLUSION: Although both of them were predictors of cardiovascular disease, NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model. NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.

Keywords: Nonalcoholic fatty liver disease, Metabolic syndrome, Coronary heart disease, Cardiovascular disease, Risk factors