Risk of cardiovascular events in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis

被引:71
作者
Alon, Livnat [1 ]
Corica, Bernadette [1 ]
Raparelli, Valeria [2 ,3 ]
Cangemi, Roberto [1 ]
Basili, Stefania [1 ]
Proietti, Marco [4 ,5 ,6 ,7 ]
Romiti, Giulio Francesco [1 ]
机构
[1] Sapienza Univ Rome, Dept Translat & Precis Med, Viale Policlin 155, I-00161 Rome, Italy
[2] Univ Ferrara, Dept Translat Med, Via Luigi Borsari 46, I-44121 Ferrara, Italy
[3] Univ Alberta, Fac Nursing, 11405 87 Ave, Edmonton, AB T6G 1C9, Canada
[4] Univ Milan, Dept Clin Sci & Community Hlth, Via Commenda 19, I-20122 Milan, Italy
[5] IRCCS Ist Clin Sci Maugeri, Geriatr Unit, Via Camaldoli 64, I-20138 Milan, Italy
[6] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool 14 3PE, Merseyside, England
[7] Liverpool Heart & Chest Hosp, Liverpool 14 3PE, Merseyside, England
关键词
NAFLD; Myocardial infarction; Ischaemic stroke; Atrial fibrillation; Heart failure; ASSOCIATION; DYSFUNCTION; MANAGEMENT; MECHANISMS; MICROBIOTA; HEALTH;
D O I
10.1093/eurjpc/zwab212
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent disease and has been repeatedly associated with an increased risk of cardiovascular disease. However, the extent of such association is unclear. We conducted a systematic review and meta-analysis of the literature to evaluate the risk of myocardial infarction (MI), ischaemic stroke (IS), atrial fibrillation (AF), and heart failure (HF) in NAFLD patients. Methods and results According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed and EMBASE, from inception to 6 March 2021, and included all studies reporting the incidence of MI, IS, AF, and HF in patients with and without NAFLD. Random-effect fmodels were used to estimate pooled odds ratio (OR), 95% confidence intervals (CI), and 95% prediction intervals (PI); subgroup analyses, meta-regressions, and sensitivity analyses were additionally performed. Among 3254 records retrieved from literature, 20 studies were included. Non-alcoholic fatty liver disease was associated with an increased risk of MI (OR: 1.66, 95% CI: 1.39-1.99, 95% PI: 0.84-3.30), IS (OR: 1.41, 95% CI: 1.29-1.55, 95% PI 1.03-1.93), AF (OR: 1.27, 95% CI: 1.18-1.37, 95% PI: 1.07-1.52), and HF (OR: 1.62, 95% CI: 1.43-1.84, 95% CI: 1.04-2.51). We identified significant subgroup differences according to geographical location, study design, NAFLD definition, and risk of bias; meta-regressions identified mean age, male sex, and study-level characteristics as potential moderators of the risk of MI and IS. Conclusions Non-alcoholic fatty liver disease was associated with increased risk of MI, IS, AF, and HF. Age, sex, and study characteristics may moderate the strength of this association. Further studies are required to evaluate specific cardiovascular prevention strategies in patients with NAFLD.
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收藏
页码:938 / 946
页数:9
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