TY - JOUR
T1 - The association of nonalcoholic fatty liver disease, obesity, and metabolic syndrome, with systemic inflammation and subclinical atherosclerosis
T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)
AU - Al Rifai, Mahmoud
AU - Silverman, Michael G.
AU - Nasir, Khurram
AU - Budoff, Matthew J.
AU - Blankstein, Ron
AU - Szklo, Moyses
AU - Katz, Ronit
AU - Blumenthal, Roger S.
AU - Blaha, Michael J.
N1 - Funding Information:
This research was supported by R01 HL071739 and contracts N01-HC-95159 through N01-HC-95165 and N01 HC 95169 from the National Heart, Lung, and Blood Institute. The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org .
Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Introduction: We characterized the association of 3 metabolic conditions - obesity, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) - with increased inflammation and subclinical atherosclerosis. Methods: We conducted cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with adequate CT imaging to diagnose NAFLD. Obesity was defined as BMI≥30kg/m2, metabolic syndrome by AHA/NHLBI criteria, and NAFLD using non-contrast cardiac CT and a liver/spleen attenuation ratio (L/S)<1. Increased inflammation was defined as high sensitivity C-reactive protein (hsCRP) ≥2mg/L and subclinical atherosclerosis as coronary artery calcium (CAC)>0. We studied the association of a stepwise increase in number of these metabolic conditions (0-3) with increased inflammation and CAC, stratifying results by gender and ethnicity. Results: Mean age of participants was 63 (±10) years, 45% were male, 37% white, 10% Chinese, 30% African American, and 23% were Hispanic. Adjusting for obesity, metabolic syndrome and traditional risk factors, NAFLD was associated with a prevalence odds ratio for hsCRP ≥2mg/L and CAC >0 of 1.47 (1.20-1.79) and 1.37 (1.11-1.68) respectively. There was a positive interaction between female gender and NAFLD in the association with hsCRP ≥2mg/L (p=0.006), with no interaction by race. With increasing number of metabolic conditions, there was a graded increase in prevalence odds ratios of hsCRP ≥2mg/L and CAC >0. Conclusion: NAFLD is associated with increased inflammation and CAC independent of traditional risk factors, obesity and metabolic syndrome. There is a graded association between obesity, metabolic syndrome, and NAFLD with inflammation and CAC.
AB - Introduction: We characterized the association of 3 metabolic conditions - obesity, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) - with increased inflammation and subclinical atherosclerosis. Methods: We conducted cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with adequate CT imaging to diagnose NAFLD. Obesity was defined as BMI≥30kg/m2, metabolic syndrome by AHA/NHLBI criteria, and NAFLD using non-contrast cardiac CT and a liver/spleen attenuation ratio (L/S)<1. Increased inflammation was defined as high sensitivity C-reactive protein (hsCRP) ≥2mg/L and subclinical atherosclerosis as coronary artery calcium (CAC)>0. We studied the association of a stepwise increase in number of these metabolic conditions (0-3) with increased inflammation and CAC, stratifying results by gender and ethnicity. Results: Mean age of participants was 63 (±10) years, 45% were male, 37% white, 10% Chinese, 30% African American, and 23% were Hispanic. Adjusting for obesity, metabolic syndrome and traditional risk factors, NAFLD was associated with a prevalence odds ratio for hsCRP ≥2mg/L and CAC >0 of 1.47 (1.20-1.79) and 1.37 (1.11-1.68) respectively. There was a positive interaction between female gender and NAFLD in the association with hsCRP ≥2mg/L (p=0.006), with no interaction by race. With increasing number of metabolic conditions, there was a graded increase in prevalence odds ratios of hsCRP ≥2mg/L and CAC >0. Conclusion: NAFLD is associated with increased inflammation and CAC independent of traditional risk factors, obesity and metabolic syndrome. There is a graded association between obesity, metabolic syndrome, and NAFLD with inflammation and CAC.
KW - Inflammation
KW - Metabolic syndrome
KW - Nonalcoholic fatty liver disease
KW - Obesity
KW - Subclinical atherosclerosis
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U2 - 10.1016/j.atherosclerosis.2015.02.011
DO - 10.1016/j.atherosclerosis.2015.02.011
M3 - Article
C2 - 25683387
AN - SCOPUS:84925507275
VL - 239
SP - 629
EP - 633
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 2
ER -