Fatty Liver, Insulin Resistance, and Features of Metabolic Syndrome: Relationships with coronary artery calcium in 10,153 people

Ki-Chul Sung*, Sarah H. Wild, Hyon Joo Kwag, Christopher D. Byrne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) coexists with insulin resistance (IR), but it is uncertain whether NAFLD and IR contribute independently to atherosclerosis. We tested whether fatty liver, IR, and metabolic syndrome (MetS) features (waist, glucose, triglyceride, HDL cholesterol [HDL-C], and blood pressure) were associated with a marker of atherosclerosis (coronary artery calcium [CAC] score > 0), independently of cardiovascular risk factors and cardiovascular disease (CVD).

RESEARCH DESIGN AND METHODS
Data were analyzed from a South Korean occupational cohort of 10,153 people who all received ultrasound measurements of fatty liver and a cardiac computed tomography CAC score. IR was defined by homeostasis model assessment of IR (HOMA-IR) >= 75th percentile. Odds ratios (ORs) (95% CIs) for the presence of a CAC score > 0 were estimated using logistic regression.

RESULTS
There were 915 people with a CAC score > 0. MetS features were increased (glucose, blood pressure, triglyceride, and waist) or decreased (HDL-C) among people with a CAC score > 0 (all comparisons against CAC score 0, 55% had fatty liver and 33.7% were insulin resistant. Fatty liver (OR 1.21 [95% CI 1.01-1.45]; P = 0.04) and HOMA-IR (1.10 [1.02-1.18]; P = 0.02) were associated with CAC score > 0, independently of all MetS features, conventional cardiovascular risk factors, and prior evidence of CVD. The presence of IR and fatty liver combined was associated with CAC score > 0 (1.53 [1.20-1.95]; P = 0.001).

CONCLUSIONS
Fatty liver and HOMA-IR are both associated with a CAC score > 0 (independently of each other), features of MetS, conventional cardiovascular risk factors, and existing CVD.

Original languageEnglish
Pages (from-to)2359-2364
Number of pages6
JournalDiabetes Care
Volume35
Issue number11
DOIs
Publication statusPublished - Nov 2012

Keywords

  • HEPATIC STEATOSIS
  • GAMMA-GLUTAMYL-TRANSFERASE
  • CALCIFICATION
  • FOLLOW-UP
  • ALANINE AMINOTRANSFERASE
  • HEART
  • MORTALITY RISK
  • COMPUTED-TOMOGRAPHY
  • CARDIOVASCULAR-DISEASE
  • POPULATION-BASED COHORT

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