Key result
NAFLD linked to ~92% greater cardiovascular disease risk versus controls.
Why the study?
NAFLD affects up to nearly a third of the Western population, but its association with cardiovascular diseases has been inconsistent.
Does the presence of non-alcoholic fatty liver disease (NAFLD) increase the risk of cardiovascular disease, subclinical atherosclerosis, and endothelial dysfunction compared to non-NAFLD controls?
Meta-Analysis
Does the presence of non-alcoholic fatty liver disease (NAFLD) increase the risk of cardiovascular disease, subclinical atherosclerosis, and endothelial dysfunction compared to non-NAFLD controls?
NAFLD is strongly and independently associated with endothelial dysfunction, subclinical atherosclerosis, and an increased risk of acute coronary syndrome, suggesting these patients may warrant detailed cardiovascular risk assessment.
NAFLD may warrant enhanced CVD risk assessment in practice; reinforces observational links but leaves causality and intervention effects open.
Background Non-alcoholic fatty liver disease (NAFLD) affects up to nearly a third of the Western population and has been inconsistently associated with cardiovascular diseases (CVDs). Therefore, we conducted a comprehensive meta-analysis to quantify the correlation of NAFLD with all major vascular diseases, acute coronary syndrome (ACS), subclinical atherosclerosis and endothelial dysfunction. Methods We searched PubMed and Embase for studies looking at the relationship between NAFLD and cardiovascular diseases published through September 2023. The parameters we used to assess cardiovascular diseases include acute coronary syndrome, brachial flow-mediated dilatation (FMD), serum asymmetric dimethylarginine (ADMA), carotid intima-media thickness (CIMT), and carotid stenosis (>50%). Data from these studies were then collected and meta-analysis was performed using the random effects model. RevMan v5.4 was used for statistical analysis. Results We interrogated a total of 114 publications which met our inclusion criteria. NAFLD patients showed statistically significant reduction in FMD% [MD: −4.83 (95% CI: −5.84 to 3.81, p < .00001)] and increased serum ADMA [MD: 0.08 (95% CI: 0.05–0.11, p < .00001)]. Mean CIMT was also increased in NAFLD patients [MD 0.13 (95% CI: 0.12–0.14, p < .00001)]. NAFLD showed a higher prevalence of pathological CIMT [MD: 0.11 (95% CI: 0.10–0.12, p < .00001)] and increased carotid plaques [OR: 2.08 (95% CI: 1.52–2.86, p < .00001)]. Furthermore, we demonstrated statistically significant increase in cardiovascular diseases among NAFLD patients compared to controls [OR: 1.92 (95% CI: 1.53–2.41, p < .00001)]. Conclusion NAFLD is a strong predictor for endothelial dysfunction, subclinical atherosclerosis and cardiovascular disease. Further studies are required to determine whether incidental findings of fatty liver on abdominal ultrasonography should prompt the need for detailed assessment of other CVD risk factors.
No takes yet. Share an insight, caveat, or question.
Mladenova et al. (2025) conducted a meta-analysis in Non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease (NAFLD) vs. Non-NAFLD (controls) was evaluated on Cardiovascular diseases (OR 1.92, 95% CI 1.53-2.41, p=<0.00001). Non-alcoholic fatty liver disease is associated with a significantly increased risk of cardiovascular diseases compared to controls (OR 1.92).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: