IMPACT OF NON-ALCOHOLIC FATTY LIVER DISEASE ON CARDIOVASCULAR RISK IN A GENERAL POPULATION

Abstract

Background and aim: Nonalcoholic fatty liver (NAFL) is a major cause of liver disease worldwide leading also to a higher risk of cardiovascular events. We aimed to evaluate the impact of fatty liver and fibrosis on cardiovascular risk factors in a general population. Materials and methods: 604 subjects included in the communitybased ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study were recruited. Steatosis (CAP >288 dB/m) and fibrosis (>8.7 KPa by M and >7.2 KPa by XL probe) were assessed with FibroScan. Cardiovascular risk was evaluated by the Atherosclerotic Cardiovascular Disease (ASCVD) risk estimator and defined low if <5%, borderline if 5%-7.4%, intermediate if 7.5%-19.9% and high if ≥20%. Intima-media thickness (IMT) was measured with ultrasound (US). Multivariate linear, ordinal and logistic regression analyses were used to identify predictors of CV risk and IMT. Results: Prevalence of steatosis and of fibrosis in this cohort were 28.6% and 6.6%, respectively. Subjects with NAFL, when compared to those without, had on average a higher IMT (0.75 vs 0.68 mm; p=0.002) and more frequently an IMT≥1mm (15.6% vs 10.4%;p=0.07), these associations being lost after adjusting for ASCVD score (p=0.66 for IMT; OR1.14,95%C.I.0.64-2.02,p=0.64 for IMT≥1mm). Patients with significant fibrosis, respect to their counterpart, had also significant higher IMT (0.8 vs 0.7 mm; p=0.005) and significant higher prevalence of IMT≥1mm (25% vs 10.9%;p=0.008) and these association were maintained after adjusting for confounders (p=0.04 for IMT;OR 2.60,95%C.I.1.10-6.12,p=0.02 for IMT≥1mm). ASCVD score was evaluated in patients with and without steatosis (Table 1) and significant fibrosis (Table 2). Notably, by ordinal regression analysis, both steatosis (OR 1.74,95%C.I.1.22-2.50, p=0.002) and significant