Severity of nonalcoholic fatty liver disease is associated with subclinical cerebro-cardiovascular atherosclerosis risk in Korean men

Background No studies have reported the relationship between nonalcoholic fatty liver disease (NAFLD) and concurrent cerebral artery and coronary artery atherosclerosis simultaneously. We aimed at determining whether NAFLD, as assessed by ultrasound, is associated with sub clinical cerebro-cardio vascular atherosclerosis (CCVA) by multidetector-row computed tomography (MDCT), and high resolution magnetic resonance angiography (HR-MRA). This cross-sectional study included men in the general Korean population aged 20-70 years. Results A total of 1,652 men participated in the study (normal, n = 835; mild-to-moderate NAFLD, n = 512; severe NAFLD, n = 305). The risk of subclinical CCVA was positively associated with age (odds ratio [OR] 1.068; 1.054-1.081, p < 0.001), body mass index (OR 1.120; 1.08 0-1.162, p < 0.001), hepatic enzyme levels (OR 1.012; 1.001-1.023, p= 0.027; OR 1.006; 1.001-1.012, p= 0.036), fasting glucose (OR 1.021; 1.015-1.027, p <0.001), triglycerides (OR 1.002; 1.000-1.003, p= 0.016), hypertension (OR 2.836; 2.268-3.546, p< 0.001), and diabetes (OR 2.911; 2.137-3.964, p< 0.001). Also, high-density lipoprotein cholesterol was inversely associated with subclinical CCVA (OR 0.974; 0.965-0.982, p< 0.001). Compared with normal controls, the OR for subclinical CCVA after full adjustment was 1.46 in the mild to -moderate NAFLD group (95% confidence interval [CI]: 1.10 to 1.93) and 2.04 in the severe NAFLD group (95% CI: 1.44 to 2.89). Conclusions Our data show that NAFLD is common among Korean men, and NAFLD severity on ultrasonography is associated with subclinical CCVA, as assessed by MDCT, and HR-MRA.