A systematic review: Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care?

Ebenezer T. Oni, Arthur S. Agatston, Michael J. Blaha, Jonathan Fialkow, Ricardo Cury, Andrei Sposito, Raimund Erbel, Ron Blankstein, Ted Feldman, Mouaz H. Al-Mallah, Raul D. Santos, Matthew J. Budoff, Khurram Nasir

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is an emerging disease and a leading cause of chronic liver disease. The prevalence in the general population is approximately 15-30% and it increases to 70-90% in obese or diabetic populations. NAFLD has been linked to increased cardiovascular disease (CVD) risk. It is therefore critical to evaluate the relationship between markers of subclinical CVD and NAFLD. Method: An extensive search of databases; including the National Library of Medicine and other relevant databases for research articles meeting inclusion criteria: observational or cohort, studies in adult populations and clearly defined NAFLD and markers of subclinical CVD. Results: Twenty-seven studies were included in the review; 16 (59%) presented the association of NAFLD and carotid intima-media thickness (CIMT), 7 (26%) the association with coronary calcification and 7 (26%) the effect on endothelial dysfunction and 6 (22%) influence on arterial stiffness. CIMT studies showed significant increases among NAFLD patients compared to controls. These were independent of traditional risk factors and metabolic syndrome. The association was similar in coronary calcification studies. The presence of NAFLD is associated with the severity of the calcification. Endothelial dysfunction and arterial stiffness showed significant independent associations with NAFLD. Two studies argued the associations were not significant; however, these studies were limited to diabetic populations. Conclusion: There is evidence to support the association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome. However, there is need for future longitudinal studies to review this association to ascertain causality and include other ethnic populations.

Original languageEnglish
Pages (from-to)258-267
Number of pages10
JournalAtherosclerosis
Volume230
Issue number2
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

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Cardiovascular Diseases
Carotid Intima-Media Thickness
Vascular Stiffness
Population
Databases
National Library of Medicine (U.S.)
Non-alcoholic Fatty Liver Disease
Causality
Longitudinal Studies
Liver Diseases
Atherosclerosis
Chronic Disease
Cohort Studies
Research

Keywords

  • Arterial stiffness
  • Carotid intima media thickness (CIMT)
  • Coronary calcification
  • Endothelial dysfunction
  • Pulse wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A systematic review : Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care? / Oni, Ebenezer T.; Agatston, Arthur S.; Blaha, Michael J.; Fialkow, Jonathan; Cury, Ricardo; Sposito, Andrei; Erbel, Raimund; Blankstein, Ron; Feldman, Ted; Al-Mallah, Mouaz H.; Santos, Raul D.; Budoff, Matthew J.; Nasir, Khurram.

In: Atherosclerosis, Vol. 230, No. 2, 01.10.2013, p. 258-267.

Research output: Contribution to journalArticle

Oni, ET, Agatston, AS, Blaha, MJ, Fialkow, J, Cury, R, Sposito, A, Erbel, R, Blankstein, R, Feldman, T, Al-Mallah, MH, Santos, RD, Budoff, MJ & Nasir, K 2013, 'A systematic review: Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care?', Atherosclerosis, vol. 230, no. 2, pp. 258-267. https://doi.org/10.1016/j.atherosclerosis.2013.07.052
Oni, Ebenezer T. ; Agatston, Arthur S. ; Blaha, Michael J. ; Fialkow, Jonathan ; Cury, Ricardo ; Sposito, Andrei ; Erbel, Raimund ; Blankstein, Ron ; Feldman, Ted ; Al-Mallah, Mouaz H. ; Santos, Raul D. ; Budoff, Matthew J. ; Nasir, Khurram. / A systematic review : Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care?. In: Atherosclerosis. 2013 ; Vol. 230, No. 2. pp. 258-267.
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abstract = "Background: Non-alcoholic fatty liver disease (NAFLD) is an emerging disease and a leading cause of chronic liver disease. The prevalence in the general population is approximately 15-30{\%} and it increases to 70-90{\%} in obese or diabetic populations. NAFLD has been linked to increased cardiovascular disease (CVD) risk. It is therefore critical to evaluate the relationship between markers of subclinical CVD and NAFLD. Method: An extensive search of databases; including the National Library of Medicine and other relevant databases for research articles meeting inclusion criteria: observational or cohort, studies in adult populations and clearly defined NAFLD and markers of subclinical CVD. Results: Twenty-seven studies were included in the review; 16 (59{\%}) presented the association of NAFLD and carotid intima-media thickness (CIMT), 7 (26{\%}) the association with coronary calcification and 7 (26{\%}) the effect on endothelial dysfunction and 6 (22{\%}) influence on arterial stiffness. CIMT studies showed significant increases among NAFLD patients compared to controls. These were independent of traditional risk factors and metabolic syndrome. The association was similar in coronary calcification studies. The presence of NAFLD is associated with the severity of the calcification. Endothelial dysfunction and arterial stiffness showed significant independent associations with NAFLD. Two studies argued the associations were not significant; however, these studies were limited to diabetic populations. Conclusion: There is evidence to support the association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome. However, there is need for future longitudinal studies to review this association to ascertain causality and include other ethnic populations.",
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T2 - Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care?

AU - Oni, Ebenezer T.

AU - Agatston, Arthur S.

AU - Blaha, Michael J.

AU - Fialkow, Jonathan

AU - Cury, Ricardo

AU - Sposito, Andrei

AU - Erbel, Raimund

AU - Blankstein, Ron

AU - Feldman, Ted

AU - Al-Mallah, Mouaz H.

AU - Santos, Raul D.

AU - Budoff, Matthew J.

AU - Nasir, Khurram

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N2 - Background: Non-alcoholic fatty liver disease (NAFLD) is an emerging disease and a leading cause of chronic liver disease. The prevalence in the general population is approximately 15-30% and it increases to 70-90% in obese or diabetic populations. NAFLD has been linked to increased cardiovascular disease (CVD) risk. It is therefore critical to evaluate the relationship between markers of subclinical CVD and NAFLD. Method: An extensive search of databases; including the National Library of Medicine and other relevant databases for research articles meeting inclusion criteria: observational or cohort, studies in adult populations and clearly defined NAFLD and markers of subclinical CVD. Results: Twenty-seven studies were included in the review; 16 (59%) presented the association of NAFLD and carotid intima-media thickness (CIMT), 7 (26%) the association with coronary calcification and 7 (26%) the effect on endothelial dysfunction and 6 (22%) influence on arterial stiffness. CIMT studies showed significant increases among NAFLD patients compared to controls. These were independent of traditional risk factors and metabolic syndrome. The association was similar in coronary calcification studies. The presence of NAFLD is associated with the severity of the calcification. Endothelial dysfunction and arterial stiffness showed significant independent associations with NAFLD. Two studies argued the associations were not significant; however, these studies were limited to diabetic populations. Conclusion: There is evidence to support the association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome. However, there is need for future longitudinal studies to review this association to ascertain causality and include other ethnic populations.

AB - Background: Non-alcoholic fatty liver disease (NAFLD) is an emerging disease and a leading cause of chronic liver disease. The prevalence in the general population is approximately 15-30% and it increases to 70-90% in obese or diabetic populations. NAFLD has been linked to increased cardiovascular disease (CVD) risk. It is therefore critical to evaluate the relationship between markers of subclinical CVD and NAFLD. Method: An extensive search of databases; including the National Library of Medicine and other relevant databases for research articles meeting inclusion criteria: observational or cohort, studies in adult populations and clearly defined NAFLD and markers of subclinical CVD. Results: Twenty-seven studies were included in the review; 16 (59%) presented the association of NAFLD and carotid intima-media thickness (CIMT), 7 (26%) the association with coronary calcification and 7 (26%) the effect on endothelial dysfunction and 6 (22%) influence on arterial stiffness. CIMT studies showed significant increases among NAFLD patients compared to controls. These were independent of traditional risk factors and metabolic syndrome. The association was similar in coronary calcification studies. The presence of NAFLD is associated with the severity of the calcification. Endothelial dysfunction and arterial stiffness showed significant independent associations with NAFLD. Two studies argued the associations were not significant; however, these studies were limited to diabetic populations. Conclusion: There is evidence to support the association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome. However, there is need for future longitudinal studies to review this association to ascertain causality and include other ethnic populations.

KW - Arterial stiffness

KW - Carotid intima media thickness (CIMT)

KW - Coronary calcification

KW - Endothelial dysfunction

KW - Pulse wave velocity

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