Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk

Eugene Han; Yong Ho Lee; Young Dae Kim; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Byung Wan Lee; Eun Seok Kang; Bong Soo Cha; Kwang Hyub Han; Hyo Suk Nam; Ji Hoe Heo; Seung Up Kim

doi:10.14309/ajg.0000000000000572

Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk

Eugene Han, Yong Ho Lee, Young Dae Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Kwang Hyub Han, Hyo Suk Nam, Ji Hoe Heo, Seung Up Kim

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Abstract

OBJECTIVES:Nonalcoholic fatty liver disease (NAFLD) and sarcopenia have a close association with an increased risk of atherosclerotic cardiovascular disease (ASCVD). This study investigated the influence of NAFLD and sarcopenia on ASCVD risk.METHODS:Data from the 2008-2011 Korean National Health and Nutrition Examination Surveys database were analyzed (n = 7,191). The sarcopenia index was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cutoffs = 0.882 for men and 0.582 for women). NAFLD was defined as a comprehensive NAFLD score ≥40. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk >10%.RESULTS:The prevalence rates of NAFLD and sarcopenia were 31.2% (n = 2,241) and 19.5% (n = 1,400), respectively. The quartile-stratified ASCVD risk scores were positively associated with NAFLD and sarcopenia (all P for trend < 0.001). Subjects with both NAFLD and sarcopenia had a higher risk for high probability of ASCVD (odds ratio = 1.83, P = 0.014) compared with controls without NAFLD and sarcopenia. Among subjects with NAFLD, FIB-4-defined significant liver fibrosis and sarcopenia additively raised the risk for high probability of ASCVD (odds ratio = 3.56, P < 0.001) compared with controls without FIB-4-defined significant liver fibrosis or sarcopenia.DISCUSSION:NAFLD and sarcopenia were significantly associated with an increased risk of ASCVD in the general population. In addition, NAFLD with significant liver fibrosis and sarcopenia were significantly associated with an increased risk of ASCVD in subjects with NAFLD.

Original language	English
Pages (from-to)	584-595
Number of pages	12
Journal	American Journal of Gastroenterology
Volume	115
Issue number	4
DOIs	https://doi.org/10.14309/ajg.0000000000000572
Publication status	Published - 2020 Apr 1

Bibliographical note

Funding Information:
Guarantor of the article: Yong-ho Lee, MD, PhD, Young Dae Kim, MD, PhD, and Seung Up Kim, MD, PhD. Specific author contributions: Conception and design: E.H., Y.h.L., Y.D.K., and S.U.K. Development of methodology: E.H., Y.h.L., Y.D.K., and S.U.K. Analysis and interpretation of data: E.H., Y.h.L., Y.D.K., and S.U.K. Writing, review, and/or revision of the manuscript: E.H., Y.h.L., Y.D.K., B.K.K., J.Y.P., D.Y.K., S.H.A., B.W.L., E.S.K., B.S.C., K.H.H., H.S.N., J.H.H., and S.U.K. Administrative, technical, or material support: E.H., Y.h.L., Y.D.K., and S.U.K. Study supervision: Y.h.L., Y.D.S., and S.U.K. Financial support: This study was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (2019R1A2C4070136, NRF-2016R1A5A1010764), by Research of Korea Centers for Disease Control and Prevention (2016-ER5103-00, 2016-ER5103-01), 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. Potential competing interests: None to report. Writing assistance: The English in this document has been checked by at least 2 professional editors, both native speakers of English (www.editage.co.kr).

Publisher Copyright:
© 2020 by The American College of Gastroenterology.

All Science Journal Classification (ASJC) codes

Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.14309/ajg.0000000000000572

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Han, E., Lee, Y. H., Kim, Y. D., Kim, B. K., Park, J. Y., Kim, D. Y., Ahn, S. H., Lee, B. W., Kang, E. S., Cha, B. S., Han, K. H., Nam, H. S., Heo, J. H., & Kim, S. U. (2020). Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk. American Journal of Gastroenterology, 115(4), 584-595. https://doi.org/10.14309/ajg.0000000000000572

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title = "Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk",

abstract = "OBJECTIVES:Nonalcoholic fatty liver disease (NAFLD) and sarcopenia have a close association with an increased risk of atherosclerotic cardiovascular disease (ASCVD). This study investigated the influence of NAFLD and sarcopenia on ASCVD risk.METHODS:Data from the 2008-2011 Korean National Health and Nutrition Examination Surveys database were analyzed (n = 7,191). The sarcopenia index was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cutoffs = 0.882 for men and 0.582 for women). NAFLD was defined as a comprehensive NAFLD score ≥40. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk >10%.RESULTS:The prevalence rates of NAFLD and sarcopenia were 31.2% (n = 2,241) and 19.5% (n = 1,400), respectively. The quartile-stratified ASCVD risk scores were positively associated with NAFLD and sarcopenia (all P for trend < 0.001). Subjects with both NAFLD and sarcopenia had a higher risk for high probability of ASCVD (odds ratio = 1.83, P = 0.014) compared with controls without NAFLD and sarcopenia. Among subjects with NAFLD, FIB-4-defined significant liver fibrosis and sarcopenia additively raised the risk for high probability of ASCVD (odds ratio = 3.56, P < 0.001) compared with controls without FIB-4-defined significant liver fibrosis or sarcopenia.DISCUSSION:NAFLD and sarcopenia were significantly associated with an increased risk of ASCVD in the general population. In addition, NAFLD with significant liver fibrosis and sarcopenia were significantly associated with an increased risk of ASCVD in subjects with NAFLD.",

author = "Eugene Han and Lee, {Yong Ho} and Kim, {Young Dae} and Kim, {Beom Kyung} and Park, {Jun Yong} and Kim, {Do Young} and Ahn, {Sang Hoon} and Lee, {Byung Wan} and Kang, {Eun Seok} and Cha, {Bong Soo} and Han, {Kwang Hyub} and Nam, {Hyo Suk} and Heo, {Ji Hoe} and Kim, {Seung Up}",

note = "Funding Information: Guarantor of the article: Yong-ho Lee, MD, PhD, Young Dae Kim, MD, PhD, and Seung Up Kim, MD, PhD. Specific author contributions: Conception and design: E.H., Y.h.L., Y.D.K., and S.U.K. Development of methodology: E.H., Y.h.L., Y.D.K., and S.U.K. Analysis and interpretation of data: E.H., Y.h.L., Y.D.K., and S.U.K. Writing, review, and/or revision of the manuscript: E.H., Y.h.L., Y.D.K., B.K.K., J.Y.P., D.Y.K., S.H.A., B.W.L., E.S.K., B.S.C., K.H.H., H.S.N., J.H.H., and S.U.K. Administrative, technical, or material support: E.H., Y.h.L., Y.D.K., and S.U.K. Study supervision: Y.h.L., Y.D.S., and S.U.K. Financial support: This study was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (2019R1A2C4070136, NRF-2016R1A5A1010764), by Research of Korea Centers for Disease Control and Prevention (2016-ER5103-00, 2016-ER5103-01), 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. Potential competing interests: None to report. Writing assistance: The English in this document has been checked by at least 2 professional editors, both native speakers of English (www.editage.co.kr). Publisher Copyright: {\textcopyright} 2020 by The American College of Gastroenterology.",

year = "2020",

month = apr,

day = "1",

doi = "10.14309/ajg.0000000000000572",

language = "English",

volume = "115",

pages = "584--595",

journal = "American Journal of Gastroenterology",

issn = "0002-9270",

publisher = "Nature Publishing Group",

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TY - JOUR

T1 - Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk

AU - Han, Eugene

AU - Lee, Yong Ho

AU - Kim, Young Dae

AU - Kim, Beom Kyung

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Lee, Byung Wan

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Han, Kwang Hyub

AU - Nam, Hyo Suk

AU - Heo, Ji Hoe

AU - Kim, Seung Up

N1 - Funding Information: Guarantor of the article: Yong-ho Lee, MD, PhD, Young Dae Kim, MD, PhD, and Seung Up Kim, MD, PhD. Specific author contributions: Conception and design: E.H., Y.h.L., Y.D.K., and S.U.K. Development of methodology: E.H., Y.h.L., Y.D.K., and S.U.K. Analysis and interpretation of data: E.H., Y.h.L., Y.D.K., and S.U.K. Writing, review, and/or revision of the manuscript: E.H., Y.h.L., Y.D.K., B.K.K., J.Y.P., D.Y.K., S.H.A., B.W.L., E.S.K., B.S.C., K.H.H., H.S.N., J.H.H., and S.U.K. Administrative, technical, or material support: E.H., Y.h.L., Y.D.K., and S.U.K. Study supervision: Y.h.L., Y.D.S., and S.U.K. Financial support: This study was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (2019R1A2C4070136, NRF-2016R1A5A1010764), by Research of Korea Centers for Disease Control and Prevention (2016-ER5103-00, 2016-ER5103-01), 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. Potential competing interests: None to report. Writing assistance: The English in this document has been checked by at least 2 professional editors, both native speakers of English (www.editage.co.kr). Publisher Copyright: © 2020 by The American College of Gastroenterology.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - OBJECTIVES:Nonalcoholic fatty liver disease (NAFLD) and sarcopenia have a close association with an increased risk of atherosclerotic cardiovascular disease (ASCVD). This study investigated the influence of NAFLD and sarcopenia on ASCVD risk.METHODS:Data from the 2008-2011 Korean National Health and Nutrition Examination Surveys database were analyzed (n = 7,191). The sarcopenia index was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cutoffs = 0.882 for men and 0.582 for women). NAFLD was defined as a comprehensive NAFLD score ≥40. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk >10%.RESULTS:The prevalence rates of NAFLD and sarcopenia were 31.2% (n = 2,241) and 19.5% (n = 1,400), respectively. The quartile-stratified ASCVD risk scores were positively associated with NAFLD and sarcopenia (all P for trend < 0.001). Subjects with both NAFLD and sarcopenia had a higher risk for high probability of ASCVD (odds ratio = 1.83, P = 0.014) compared with controls without NAFLD and sarcopenia. Among subjects with NAFLD, FIB-4-defined significant liver fibrosis and sarcopenia additively raised the risk for high probability of ASCVD (odds ratio = 3.56, P < 0.001) compared with controls without FIB-4-defined significant liver fibrosis or sarcopenia.DISCUSSION:NAFLD and sarcopenia were significantly associated with an increased risk of ASCVD in the general population. In addition, NAFLD with significant liver fibrosis and sarcopenia were significantly associated with an increased risk of ASCVD in subjects with NAFLD.

AB - OBJECTIVES:Nonalcoholic fatty liver disease (NAFLD) and sarcopenia have a close association with an increased risk of atherosclerotic cardiovascular disease (ASCVD). This study investigated the influence of NAFLD and sarcopenia on ASCVD risk.METHODS:Data from the 2008-2011 Korean National Health and Nutrition Examination Surveys database were analyzed (n = 7,191). The sarcopenia index was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cutoffs = 0.882 for men and 0.582 for women). NAFLD was defined as a comprehensive NAFLD score ≥40. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk >10%.RESULTS:The prevalence rates of NAFLD and sarcopenia were 31.2% (n = 2,241) and 19.5% (n = 1,400), respectively. The quartile-stratified ASCVD risk scores were positively associated with NAFLD and sarcopenia (all P for trend < 0.001). Subjects with both NAFLD and sarcopenia had a higher risk for high probability of ASCVD (odds ratio = 1.83, P = 0.014) compared with controls without NAFLD and sarcopenia. Among subjects with NAFLD, FIB-4-defined significant liver fibrosis and sarcopenia additively raised the risk for high probability of ASCVD (odds ratio = 3.56, P < 0.001) compared with controls without FIB-4-defined significant liver fibrosis or sarcopenia.DISCUSSION:NAFLD and sarcopenia were significantly associated with an increased risk of ASCVD in the general population. In addition, NAFLD with significant liver fibrosis and sarcopenia were significantly associated with an increased risk of ASCVD in subjects with NAFLD.

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Nonalcoholic Fatty Liver Disease and Sarcopenia Are Independently Associated with Cardiovascular Risk

Abstract

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UN SDGs

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