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ȣ - 520252 350 |
| The Relation between Non-alcoholic Fatty Liver Disease and the Risk of Coronary Heart Disease in Koreans |
| 서울대학교병원 헬스케어시스템 강남센터, 내과 ¹ ;서울대학교병원 헬스케어시스템 강남센터, 영상의학과² ;서울대학교병원, 내과 ³ |
| 최수연¹, 김동희¹ , 강진화 ² , 오병희³ |
BACKGROUND and AIMS: Non-alcoholic Fatty Liver Disease (NAFLD) is known to be related to factors that predict the development of coronary heart disease (CHD), such as, dyslipidemia, central obesity, and metabolic syndrome (MS). The aim of this study was to determine whether subjects with NAFLD have an elevated risk of CHD, as estimated using Framingham risk score (FRS). METHODS: 17840 subjects without known causes of liver disease and history of heart disease that underwent a voluntary general health examination were recruited. NAFLD was diagnosed based on typical sonographic findings and an alcohol consumption of < 20 grams/day. RESULTS: NAFLD was diagnosed in 5888 of 17840 (32.9%) subjects. The 5888 subjects with NAFLD were split into two groups based on ultrasonographic findings, into a mild NAFLD group [n=3356] and a moderate-severe NAFLD group [n=2532]. Multivariable regression analysis, adjusted for age, BMI, and each component of metabolic syndrome, showed a strong association between NAFLD severity and more than moderate risk of CHD by FRS (10-year CHD risk ≥ 10%) in men and women. CONCLUSION: Koreans with ultrasonographically detected NAFLD have an elevated 10-year risk of developing CHD as estimated using FRS independently regardless of classical risk factors and other components of metabolic syndrome.
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Results of multinomial logistic regression analysis to assess the influence of NAFLD on more than moderate risk stratification by Framingham risk score (10year-CHD risk ≥ 10%): Adjusted by age, BMI, and each component of metabolic syndrome
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male |
female |
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|
OR |
95% CI |
P-value |
OR |
95% CI |
P-value |
|
Mild NAFLD |
1.44 |
1.23-1.69 |
<0.01 |
1.30 |
0.96-1.77 |
0.91 |
|
Severe NAFLD |
1.73 |
1.45-2.06 |
<0.01 |
1.88 |
1.35-2.60 |
<0.01 |
|
WC |
0.94 |
0.79-1.11 |
0.47 |
1.02 |
0.71-1.48 |
0.91 |
|
TG |
3.03 |
2.61-3.52 |
<0.01 |
2.39 |
1.81-3.16 |
<0.01 |
|
HDL |
1.99 |
1.70-2.33 |
<0.01 |
9.55 |
7.26-12.56 |
<0.01 |
|
BP |
4.10 |
3.59-4.68 |
<0.01 |
12.70 |
9.65-16.70 |
<0.01 |
|
FPG |
1.53 |
1.34-1.74 |
<0.01 |
3.82 |
2.97-4.92 |
<0.01 |
|
Age |
1.20 |
1.19-1.21 |
<0.01 |
1.14 |
1.13-1.16 |
<0.01 |
|
BMI |
1.08 |
1.04-1.12 |
<0.01 |
1.00 |
0.99-1.01 |
0.75 |
WC = waist circumference > 90 cm (men) and > 80 cm (women); TG = triglyceride levels >150 mg/dL or current use of fibrates; HDL = HDL-cholesterol < 40 mg/dL (men) and < 50 mg/dL (women); BP = arterial pressure ≥ 130/85 mmHg or pharmacologically treated, FPG = fasting plasma glucose ≥ 100mg/dL or treated for diabetes.
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