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January 1, 2021Gastroenterology ReviewOpen Access

Association of non-alcoholic fatty liver diseasewith coronary artery calcification progression:a systematic review and meta-analysis

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Key result

Non-alcoholic fatty liver disease is associated with significantly increased odds of coronary artery calcification progression over time (OR 1.5).

Why the study?

Coronary artery calcification progression strongly predicts cardiovascular events, but the association between NAFLD and the progression of CAC over time required assessment.

Does non-alcoholic fatty liver disease increase the progression of coronary artery calcification in adults?

Population

10,060 adults across 4 observational studies

Comparison

NAFLD vs no NAFLD

Design

Systematic review and meta-analysis of observational studies

Authors

GKGeorge KoulaouzidisDCDafni CharisopoulouMKMichał Kukla

Discussion

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Member takes

Overview

NAFLD warrants CV risk assessment in practice; reinforces metabolic-atherosclerosis links via Level 1 meta-analysis.

Study Design

Type

Meta-Analysis (n=10,060)

Structured PICO

Does non-alcoholic fatty liver disease increase the progression of coronary artery calcification in adults?

P
Population
10,060 adults from 4 longitudinal observational studies with and without NAFLD, evaluated for coronary artery calcification progression over time.
E
Exposure
Presence of non-alcoholic fatty liver disease (NAFLD)
C
Comparator
Absence of non-alcoholic fatty liver disease (NAFLD)
O
Outcome
Progression of coronary artery calcification (CAC) over timesurrogate

Main Result

Odds Ratio: 1.5 (95% CI 1.34–1.68)

p-value: p=0.001

Non-alcoholic fatty liver disease is independently associated with an increased risk of coronary artery calcification progression, highlighting its role as a marker for advancing subclinical atherosclerosis.

Limitations

  • Retrospective nature of most included studies
  • Potential measurement errors due to different CT scanners and radiology personnel
  • NAFLD diagnosis based on standard ultrasound, which can lead to false diagnosis in 10% to 30% of cases and cannot diagnose the full spectrum of the disease (e.g., steatohepatitis and fibrosis)
  • Retrospective nature of the studies
  • Selection bias as study populations consisted only of subjects who repeated a second CT scan
  • Different CT scanners and radiology personnel were involved in performing CACs
  • NAFLD was diagnosed with standard ultrasound, which can lead to a false diagnosis in 10% to 30% of cases

Cite This Study

Koulaouzidis et al. (2021) conducted a meta-analysis in Non-alcoholic fatty liver disease (NAFLD) (n=10,060). Non-alcoholic fatty liver disease (NAFLD) vs. Participants without NAFLD was evaluated on Progression of coronary artery calcification (CAC) (OR 1.5, 95% CI 1.34-1.68, p=0.001). Non-alcoholic fatty liver disease is associated with significantly increased odds of coronary artery calcification progression over time (OR 1.5).

synapsesocial.com/papers/6a74bca799129e9915f550e3https://doi.org/10.5114/pg.2021.109063
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Non-alcoholic fatty liver disease and progression of coronary artery calcium score: a retrospective cohort study2016 · 165 citations
  2. 2Nonalcoholic Fatty Liver Disease Is Associated With Coronary Artery Calcification Development: A Longitudinal Study2016 · 71 citations
  3. 3Non-alcoholic fatty liver disease is a strong predictor of coronary artery calcification in metabolically healthy subjects: A cross-sectional, population-based study in middle-aged subjects2018 · 40 citations
  4. 4Association between noninvasive assessment of liver fibrosis and coronary artery calcification progression in patients with nonalcoholic fatty liver disease2020 · 37 citations
  5. 5Association between the Severity of Nonalcoholic Fatty Liver Disease and the Risk of Coronary Artery Calcification2021 · 11 citations