Fatty liver index correlates with non-alcoholic fatty liver disease, but not with newly diagnosed coronary artery atherosclerotic disease in Chinese patients

BMC Gastroenterology

Li-Fen Yu¹  Xiao-Bo Yang¹  Lu-Ying Sun¹  Wei-Wei Li¹  Xian-Xing Chang¹  Chen-Ying Xu¹  Zhao-Yan Jiang² 

[1] Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China;Department of Surgery, Shanghai Institute of Digestive Surgery, Shanghai, 200025, China

关键词: Coronary angiography;    Coronary artery atherosclerotic disease;    Non-alcoholic fatty liver disease;    Fatty liver index;   

Others  :  857841
DOI  :  10.1186/1471-230X-13-110

 received in 2012-11-08, accepted in 2013-06-20,  发布年份 2013

【 摘 要 】

Background

Fatty liver index (FLI) was recently established to predict non-alcoholic fatty liver disease (NAFLD) in general population, which is known to be associated with coronary artery atherosclerotic disease (CAD).

This study aims to investigate whether FLI correlates with NAFLD and with newly diagnosed CAD in a special Chinese population who underwent coronary angiography.

Methods

Patients with CAD (n = 231) and without CAD (n = 482) as confirmed by coronary angiography were included. Among them, 574 patients underwent B-ultrosonography were divided into NAFLD group (n = 209) and non-NAFLD group (n = 365). Correlation between FLI and NAFLD was analyzed using pearson’s correlation. The associations between FLI and NAFLD as well as CAD were assessed using logistic regression. The predictive accuracy of FLI for NAFLD was evaluated using receiver operating characteristics (ROC) curve analysis.

Results

FLI was significantly higher in NAFLD group (37.10 ± 1.95) than in non-NAFLD group (17.70 ± 1.04), P < 0.01. FLI correlated with NAFLD (r = 0.372, P < 0.001). The algorithm for FLI had a ROC-AUC of 0.721 (95% CI: 0.678–0.764) in the prediction of NAFLD. Logistic regression analysis showed that FLI was associated with NAFLD (adjusted OR = 1.038, 95% CI: 1.029-1.047, P < 0.01). The proportion of patients with CAD did not differ among the groups of FLI ≤ 30 (32.3%), 30-60 (31.0%), and ≥60 (35.3%). No significant association was found between FLI and CAD (adjusted OR = 0.992, 95% CI: 0.981-1.003 in men and OR = 0.987, 95% CI: 0.963-1.012 in women, P > 0.05).

Conclusions

FLI showed good correlation with NAFLD in patients who underwent coronary angiography, but not with newly diagnosed CAD. This might be underestimated because some patients in non-CAD group may have other underlying cardiovascular diseases.

【 授权许可】

   
2013 Jiang et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Chitturi S, Farrell GC, Hashimoto E, Saibara T, Lau GK, Sollano JD: Non-alcoholic fatty liver disease in the Asia-Pacific region: definitions and overview of proposed guidelines. J Gastroenterol Hepatol 2007, 22(6):778-787.
• [2]Fan JG, Farrell GC: Epidemiology of non-alcoholic fatty liver disease in China. J Hepatol 2009, 50(1):204-210.
• [3]de Alwis NM, Day CP: Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol 2008, 48(Suppl 1):S104-S112.
• [4]Farrell GC, Larter CZ: Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology 2006, 43(2 Suppl 1):S99-S112.
• [5]Vuppalanchi R, Chalasani N: Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: selected practical issues in their evaluation and management. Hepatology 2009, 49(1):306-317.
• [6]Bedogni G, Bellentani S, Miglioli L, Masutti F, Passalacqua M, Castiglione A, Tiribelli C: The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol 2006, 6:33. BioMed Central Full Text
• [7]Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJ, Chutaputti A: What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol 2007, 22(6):794-800.
• [8]Emond M, Mock MB, Davis KB, Fisher LD, Holmes DR Jr, Chaitman BR, Kaiser GC, Alderman E, Killip T 3rd: Long-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) Registry. Circulation 1994, 90(6):2645-2657.
• [9]Saverymuttu SH, Joseph AE, Maxwell JD: Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J (Clin Res Ed) 1986, 292(6512):13-15.
• [10]Joseph AE, Saverymuttu SH, Al-Sam S, Cook MG, Maxwell JD: Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol 1991, 43(1):26-31.
• [11]Expert WHO: Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004, 363(9403):157-163.
• [12]Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009, 120(16):1640-1645.
• [13]Kim JH, Kwon SY, Lee SW, Lee CH: Validation of fatty liver index and lipid accumulation product for predicting fatty liver in Korean population. Liver Int 2011, 31(10):1600-1601.
• [14]Lin YC, Lo HM, Chen JD: Sonographic fatty liver, overweight and ischemic heart disease. World J Gastroenterol 2005, 11(31):4838-4842.
• [15]Villanova N, Moscatiello S, Ramilli S, Bugianesi E, Magalotti D, Vanni E, Zoli M, Marchesini G: Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology 2005, 42(2):473-480.
• [16]Dunn W, Xu R, Wingard DL, Rogers C, Angulo P, Younossi ZM, Schwimmer JB: Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study. Am J Gastroenterol 2008, 103(9):2263-2271.
• [17]Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H: Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults. Circulation 2005, 112(14):2130-2137.
• [18]Lee DS, Evans JC, Robins SJ, Wilson PW, Albano I, Fox CS, Wang TJ, Benjamin EJ, D'Agostino RB, Vasan RS: Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2007, 27(1):127-133.
• [19]Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ: Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 1999, 116(6):1413-1419.
• [20]Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A, Angulo P: The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 2005, 129(1):113-121.
• [21]Rafiq N, Bai C, Fang Y, Srishord M, McCullough A, Gramlich T, Younossi ZM: Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol 2009, 7(2):234-238.
• [22]Targher G, Arcaro G: Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis 2007, 191(2):235-240.
• [23]Kotronen A, Yki-Jarvinen H: Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vasc Biol 2008, 28(1):27-38.
• [24]Calori G, Lattuada G, Ragogna F, Garancini MP, Crosignani P, Villa M, Bosi E, Ruotolo G, Piemonti L, Perseghin G: Fatty liver index and mortality: the Cremona study in the 15th year of follow-up. Hepatology 2011, 54(1):145-152.
• [25]Gastaldelli A, Kozakova M, Hojlund K, Flyvbjerg A, Favuzzi A, Mitrakou A, Balkau B: Fatty liver is associated with insulin resistance, risk of coronary heart disease, and early atherosclerosis in a large European population. Hepatology 2009, 49(5):1537-1544.
• [26]Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, et al.: Heart disease and stroke statistics–2011 update: a report from the American Heart Association. Circulation 2011, 123(4):e18-e209.
• [27]Yang W, Xiao J, Yang Z, Ji L, Jia W, Weng J, Lu J, Shan Z, Liu J, Tian H, et al.: Serum Lipids and Lipoproteins in Chinese Men and Women. Circulation 2012, 125(18):2212-2221.