TY - JOUR
T1 - Sex-influenced association of nonalcoholic fatty liver disease with coronary heart disease
AU - Feitosa, Mary F.
AU - Reiner, Alexander P.
AU - Wojczynski, Mary K.
AU - Graff, Mariaelisa
AU - North, Kari E.
AU - Carr, Jeffrey J.
AU - Borecki, Ingrid B.
N1 - Funding Information:
This study was supported by the by R01-DK-8925601 and R01-DK-075681 (Ingrid B. Borecki, PI) from NIDDK , and R01-HL-087700 and R01-HL-088215 (Michael A. Province, PI) from NHLBI .
PY - 2013/4
Y1 - 2013/4
N2 - Objective: This study investigated whether nonalcoholic fatty liver disease (NAFLD) predicts prevalent coronary heart disease (CHD). Methods: Epidemiologic studies have used various definitions for NAFLD. Here, we considered both liver fat burden measured by CT (FL) and the non-specific measure of hepatic inflammation -alanine aminotransferase (ALT). The association of FL and ALT with CHD (self report of coronary bypass, myocardial infarction, or percutaneous transluminal coronary angioplasty) was investigated in 2756 European-American participants of the Family Heart Study. Results: FL (p = 0.0084) and ALT (≥40 U/L, p = 0.014) were each individually associated with prevalent CHD. However, when accounting for traditional metabolic risk factors in a multivariate model FL had no predictive value for CHD in either men or women; whereas ALT was a significant predictor of CHD in men, and the association strengthened among non-diabetic men. In non-diabetic women, neither FL nor ALT was associated with CHD. Conclusions: ALT (≥40 U/L) was a predictor of prevalent CHD in men but not in women, while CT measured FL was not significant in either sex. The failure to account for traditional risk factors, heterogeneity by sex, and varying definitions of NAFLD may account for some of the conflicting evidence in the literature regarding the association between NAFLD and coronary disease.
AB - Objective: This study investigated whether nonalcoholic fatty liver disease (NAFLD) predicts prevalent coronary heart disease (CHD). Methods: Epidemiologic studies have used various definitions for NAFLD. Here, we considered both liver fat burden measured by CT (FL) and the non-specific measure of hepatic inflammation -alanine aminotransferase (ALT). The association of FL and ALT with CHD (self report of coronary bypass, myocardial infarction, or percutaneous transluminal coronary angioplasty) was investigated in 2756 European-American participants of the Family Heart Study. Results: FL (p = 0.0084) and ALT (≥40 U/L, p = 0.014) were each individually associated with prevalent CHD. However, when accounting for traditional metabolic risk factors in a multivariate model FL had no predictive value for CHD in either men or women; whereas ALT was a significant predictor of CHD in men, and the association strengthened among non-diabetic men. In non-diabetic women, neither FL nor ALT was associated with CHD. Conclusions: ALT (≥40 U/L) was a predictor of prevalent CHD in men but not in women, while CT measured FL was not significant in either sex. The failure to account for traditional risk factors, heterogeneity by sex, and varying definitions of NAFLD may account for some of the conflicting evidence in the literature regarding the association between NAFLD and coronary disease.
KW - Cardiovascular disease
KW - Glucose metabolism
KW - Insulin resistance
KW - Nonalcoholic steatohepatitis
KW - Sex-specific association
UR - http://www.scopus.com/inward/record.url?scp=84875056135&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2013.01.013
DO - 10.1016/j.atherosclerosis.2013.01.013
M3 - Article
C2 - 23390892
AN - SCOPUS:84875056135
SN - 0021-9150
VL - 227
SP - 420
EP - 424
JO - Atherosclerosis
JF - Atherosclerosis
IS - 2
ER -