Sex-influenced association of nonalcoholic fatty liver disease with coronary heart disease.

Feitosa MF, Reiner AP, Wojczynski MK, Graff M, North KE, Carr JJ, Borecki IB
Atherosclerosis. 2013 227 (2): 420-4

PMID: 23390892 · PMCID: PMC3602396 · DOI:10.1016/j.atherosclerosis.2013.01.013

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.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

MeSH Terms (20)

Aged Alanine Transaminase Angioplasty Coronary Disease Fatty Liver Female Humans Inflammation Insulin Resistance Liver Male Middle Aged Multivariate Analysis Myocardial Infarction Non-alcoholic Fatty Liver Disease Oxidative Stress Phenotype Predictive Value of Tests Risk Factors Sex Factors

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