Cardiovascular Risk Is Elevated in Lean Subjects with Nonalcoholic Fatty Liver Disease

Yuna Kim, Eugene Han, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Mi Kyung Kim, Hye Soon Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Yong Ho Lee, Seung Up Kim

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) and obesity are independently associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD), the leading cause of mortality in patients with NAFLD. Many NAFLD patients are lean, but their ASCVD risk compared to obese subjects with NAFLD is unclear. Methods: Data from the 2008 to 2011 Korea National Health and Nutrition Examination Surveys database were analyzed (n=4,786). NAFLD was defined as a comprehensive NAFLD score ≥40 or a liver fat score ≥-0.640. ASCVD risk was evaluated using the American College of Cardiology/American Heart Association guidelines. Results: The frequency of subjects without NAFLD, with obese NAFLD, and with lean NAFLD was 62.4% (n=2,987), 26.6% (n=1,274), and 11.0% (n=525), respectively. Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of a high ASCVD risk (mean 15.6±14.0, 51.6%) than those with obese NAFLD and without NAFLD (mean 11.2±11.4, 39.8%; mean 7.9±10.9, 25.5%; all p<0.001). Subjects with lean NAFLD and significant liver fibrosis showed a significantly higher odds ratio for a high risk for ASCVD than those with obese NAFLD with or without significant liver fibrosis (odds ratio, 2.60 vs 1.93; p=0.023). Conclusions: Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of high risk for ASCVD than those with obese NAFLD. Similarly, lean subjects with significant liver fibrosis had a higher probability of ASCVD than obese subjects in the subpopulation with NAFLD.

Original languageEnglish
Pages (from-to)290-299
Number of pages10
JournalGut and liver
Volume16
Issue number2
DOIs
Publication statusPublished - 2022

Bibliographical note

Funding Information:
This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (2019R1A2C4070136), by the Ministry of Education (2018R1D1A1B07050005), and by the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare (HI17C0913), Republic of Korea. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© Gut and Liver

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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