scholarly journals Coronary Artery Disease is More Severe in Patients with Non-Alcoholic Steatohepatitis than Fatty Liver

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 129
Author(s):  
Toshihiro Niikura ◽  
Kento Imajo ◽  
Anna Ozaki ◽  
Takashi Kobayashi ◽  
Michihiro Iwaki ◽  
...  

Non-alcoholic fatty liver disease (NAFLD) is associated with a higher risk of atherosclerotic disease. However, the relationships between the severity of coronary atherosclerosis and pathologic findings in patients with NAFLD remain unknown. We aimed to characterize the coronary artery lesions in patients with NAFLD using coronary computed tomography angiography (CCTA). Overall, 101 patients with liver biopsy-proven NAFLD who had chest pain or electrocardiographic abnormalities underwent CCTA. Coronary artery lesions, including coronary artery stenosis (CAS), calcium score (CACS, Agatston score), and coronary artery non-calcified plaque were assessed using multi-slice CT. Multivariate analysis showed that age, smoking status, prevalence of dyslipidemia (DLP) and non-alcoholic steatohepatitis (NASH), and stage of fibrosis were independent risk factors for CAS. Age, and the prevalence of DM and DLP, were independent risk factors for CACS, and the prevalence of NASH tended to be an independent risk factor. In addition, the prevalence of DLP and NASH were independent risk factors for non-calcified plaques. Coronary artery lesions are more common in patients with NASH than in those with non-alcoholic fatty liver, suggesting a higher risk in patients with NASH. Therefore, patients with NASH should be closely followed, with particular vigilance for coronary artery diseases.

2016 ◽  
Vol 64 (2) ◽  
pp. S498
Author(s):  
S. Zelber-Sagi ◽  
S. Azar ◽  
A. Nemirovski ◽  
M. Webb ◽  
Z. Halpern ◽  
...  

2012 ◽  
Vol 49 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Mônica Rodrigues de Araújo Souza ◽  
Margareth de Fátima Formiga de Melo Diniz ◽  
José Eymard Moraes de Medeiros-Filho ◽  
Maria Salete Trigueiro de Araújo

CONTEXT: Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma. OBJECTIVE: To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention. METHOD: PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected. RESULTS: The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed. CONCLUSION: Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies.


2021 ◽  
Author(s):  
Jinling Hu ◽  
Weidong Ren

Abstract Objective:To identify factors predictive of coronary artery lesions (CALs) in children with Kawasaki disease (KD).Methods:The clinical data of 420 children with KD who were hospitalized between January 2018 and December 2020 were retrospectively evaluated after assignment to groups by the presence of coronary artery aneurysm (CAA), coronary artery dilation (CAD), or no CALs. The association between coronary artery damage and patient clinical and laboratory values was investigated by pairwise comparison of the three groups. Univariate and multivariate logistic regression identified independent risk factors. The predictive value of patient variables for development of CAA and CAD was estimated by receiver operating characteristic curve analysis.Results:CALs occurred in 17.6% (94/420) of children with KD. Duration of fever, cervical lymphadenopathy, intravenous immune globulin resistance, immunoglobulin (Ig)A, procalcitonin, hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein, and others differed between patients with CALs and without CALs and were significantly associated with the development of CAA and CAD. The largest area under the curve was for combined CAA or CAD indicators, 0.851 for CAA (sensitivity of 68.09% and specificity of 60.62%) and 0.714 for CAD (sensitivity of 65.96% and specificity of 70.77%). Fever of >7 days before treatment was predictive of severe CAA or CAD.Conclusion:Fever duration, ESR, IgA, Hb, and cervical lymphadenopathy were independent risk factors of CAA; CRP, ESR, and cervical lymphadenopathy were independent risk factors of CAD, with combined factors having increased sensitivity and specificity. Early, active treatment is essential to reduce the occurrence of CALs.


2015 ◽  
Vol 35 (8) ◽  
pp. 1983-1991 ◽  
Author(s):  
Carmelo García-Monzón ◽  
Javier Vargas-Castrillón ◽  
José Luís Porrero ◽  
María Teresa Alonso ◽  
Oscar Bonachía ◽  
...  

Author(s):  
Granth Kumar ◽  
Ganga Prasad Vaishya ◽  
Vijayavarman V. ◽  
Saleem Ahmad ◽  
Pawan Kumar ◽  
...  

Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States and other industrialized countries, many study has identified NAFLD as a risk factor not only for premature coronary artery disease and cardiovascular events, but also for early subclinical abnormalities in myocardial structure and function. Aim of this study was to the presence of NAFLD in patients with Ischemic Heart Disease (IHD) and Relation of NAFLD with other risk factors of IHD.Methods: The study group consisted of 150 patients that comply with inclusion criteria and selected of 100 consecutive patients who underwent coronary angiographies. Coronary artery disease was defined as a stenosis at least 50% in at least one major coronary artery. Fatty liver was diagnosed by abdominal ultrasonography (4 stages: Grades 0, 1, 2 and 3). Statistical evaluations were performed using T test, Chi- square test.Results: The present study was done in 100 patients of coronary artery disease divided into two groups i.e. Non NAFLD group n= 62 (62%) and NAFLD group n= 38 (38%). The present study shows that the prevalence of NAFLD was highest (86.8%) in more than 40 years of age group. The present study shows that the prevalence of NAFLD was more in males (84.2%) as compare to females (15.8%). The present study also shows significantly high incidence of metabolic syndrome in patients with NAFLD (23.7%) as compared to Non-NAFLD (3.2%) patients with Coronary Artery (CAD).Conclusions: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. The study results suggest the synergistic effect in between fatty liver and deranged lipid profile for developing IHD. Abdominal ultrasonography may provide valuable information about IHD risk assessment.


2020 ◽  
Vol 18 ◽  
Author(s):  
Georgios Sfikas ◽  
Michael Psallas ◽  
Charalambos Koumaras ◽  
Konstantinos Imprialos ◽  
Evangelos Perdikakis ◽  
...  

Background: Non-alcoholic fatty liver disease (NAFLD) and its severe form, non-alcoholic steatohepatitis (NASH), are major health problems worldwide. Genetics may play a role in the pathogenesis of NAFLD/NASH. Aim: To investigate the prevalence of NAFLD/NASH in 5,400 military personnel and evaluate the effect of treatment with 3 statins on NAFLD/NASH using 2 non-invasive scores [NAFLD Activity Score (NAS); Fibrosis-4 score (FIB-4)]. Methods: During the mandatory annual medical check-up, military personnel underwent a clinical and laboratory evaluation. Participants with NAFLD/NASH were randomised to 4 groups (n=151 each): dietexercise, atorvastatin, rosuvastatin or pitavastatin for 1 year (i.e. until the next routine evaluation). Results: From all the participants, 613 had NAFLD/NASH (prevalence 11.3 vs 39.8% in the general population, p<0.001); 604 consented to participate in the study. After a year of treatment, the diet-exercise group showed no significant changes in both scores (NAS 4.98 baseline vs 5.62, p=0.07; FIB-4 3.42 vs 3.52, p=0.7). For the atorvastatin group, both scores were reduced (NAS 4.97 vs 1.95, p<0.001, FIB-4 3.56 vs 0.83, p<0.001), for rosuvastatin (NAS 5.55 vs 1.81, p<0.001, FIB-4 3.61 vs 0.79, p<0.001), and for pitavastatin (NAS 4.89 vs 1.99, p<0.001, FIB-4 3.78 vs 0.87, p<0.001). Conclusions : Atorvastatin, rosuvastatin and pitavastatin have a beneficial and safe effect in NAFLD/NASH patients as recorded by the improvement in the NAS (representing NAFLD activity) and FIB-4 (representing liver fibrosis) scores. Since both those with and without NAFLD/NASH shared several baseline characteristics, genetics may play a role in the pathogenesis of NAFLD/NASH and its treatment with statins.


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