Association between Nonalcoholic Fatty Liver Disease (NAFLD) and Coronary Artery Disease (CAD) in Patients with Angina Pectoris
Author(s)
Atoosa Adibi,
Majid Jaberzadeh-Ansari*,
Amir-Reza Dalili,
Navid Omidifar,
Masoumeh Sadeghi
Affiliation(s)
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Cardiac Rehabilitation Research Center, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Cardiac Rehabilitation Research Center, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
ABSTRACT
Background: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in Iranian population. The aim of this study was the investigation of association between nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) in patients with angina pectoris. Methods: 82 patients with confirmed CAD by coronary angiography and 82 individuals with normal coronary angiography, as the control group, were selected. Hepatic ultrasound scanning was performed in all the subjects to determinate the NAFLD. Data were analyzed by SPSS software and independent T-test and Chi-square tests. Results: Findings gathered from the patients with angina pectoris showed that the prevalence of NAFLD in CAD patients was higher than the control group. Grade of fatty liver and the portal vein size in CAD patients were significantly more than the control group. Conclusion: NAFLD is a risk factor of CAD in the angina pectoris patients. Increase in the prevalence of NAFLD can lead to the increase in cardiovascular diseases.
Cite this paper
A. Adibi, M. Jaberzadeh-Ansari, A. Dalili, N. Omidifar and M. Sadeghi, "Association between Nonalcoholic Fatty Liver Disease (NAFLD) and Coronary Artery Disease (CAD) in Patients with Angina Pectoris," Open Journal of Medical Imaging, Vol. 3 No. 3, 2013, pp. 97-101. doi: 10.4236/ojmi.2013.33015.
A. Adibi, M. Jaberzadeh-Ansari, A. Dalili, N. Omidifar and M. Sadeghi, "Association between Nonalcoholic Fatty Liver Disease (NAFLD) and Coronary Artery Disease (CAD) in Patients with Angina Pectoris," Open Journal of Medical Imaging, Vol. 3 No. 3, 2013, pp. 97-101. doi: 10.4236/ojmi.2013.33015.
References
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[1] G. C. Farrell and C. Z. Larter, “Nonalcoholic Fatty Liver Disease: From Steatosis to Cirrhosis,” Hepatology, Vol. 43, No. 2, 2006, pp. 99-112. doi:10.1002/hep.20973 [2] J. D. Browning, L. S. Szczepaniak, R. Dobbins, P. Nur- emberg, J. D. Horton, J. C. Cohen, et al., “Prevalence of Hepatic Steatosis in an Urban Population in the United States: Impact of Ethnicity,” Hepatology, Vol. 40, No. 6, 2004, pp. 1387-1395. doi:10.1002/hep.20466 [3] J. A. Welsh, S. Karpen and M. B. Vos, “Increasing Prevalence of Nonalcoholic Fatty Liver Disease among United States Adolescents, 1988-1994 to 2007-2010,” Journal of Pediatrics, Vol. 162, No. 3, 2013, pp. 496-500. doi:10.1016/j.jpeds.2012.08.043 [4] G. Bedogn, L. Miglioli, F. Masutti, C. Tiribelli, G. Marchesini and S. Bellentani, “Prevalence of and Risk Factors for Nonalcoholic Fatty Liver Disease: The Dionysos Nutrition and Liver Study,” Hepatology, Vol. 42, No. 1, 2005, pp. 44-52. doi:10.1002/hep.20734 [5] X. Hu, Y. Huang, Z. Bao, Y. Wang, D. Shi, F. Liu, et al., “Prevalence and Factors Associated with Nonalcoholic Fatty Liver Disease in Shanghai Work-Units,” BMC Gastroenterology, Vol. 12, No. 1, 2012, p. 123. doi:10.1186/1471-230X-12-123 [6] X. Ying, Y. Jiang, Y. Qian, Z. Jiang, Z. Song and C. Zhao, “Association between Insulin Resistance, Metabolic Syndrome and Nonalcoholic Fatty Liver Disease in Chinese Adults,” Iranian Journal of Public Health, Vol. 41, No. 1, 2012, pp. 45-49. [7] G. Musso, R. Gambino, S. Bo, B. Uberti, G. Biroli, G. Pagano, et al., “Should nonalcoholic Fatty Liver Disease Be Included in the Definition of Metabolic Syndrome? A Cross-Sectional Comparison with Adult Treatment Panel III Criteria in Nonobese Nondiabetic Subjects,” Diabetes Care, Vol. 31, No. 3, 2008, pp. 562-568. doi:10.2337/dc07-1526 [8] M. Hamaguchi, N. Takeda, T. Kojima, A. Ohbora, T. Kato, H. Sarui, et al., “Identification of Individuals with Non-Alcoholic Fatty Liver Disease by the Diagnostic Criteria for the Metabolic Syndrome,” World Journal of Gastroenterology, Vol. 18, No. 13, 2012, pp. 1508-1516. doi:10.3748/wjg.v18.i13.1508 [9] W. Nseir, A. Shalata, A. Marmor and N. Assy, “Mechanisms Linking Nonalcoholic Fatty Liver Disease with Coronary Artery Disease,” Digestive Diseases and Sciences, Vol. 56, No. 12, 2011, pp. 3439-3449. doi:10.1007/s10620-011-1767-y [10] C. Ruhl and J. Everhart, “Epidemiology of Nonalcoholic Fatty Liver,” Clinical Liver Disease, Vol. 8, No. 3, 2004, pp. 501-519. doi:10.1016/j.cld.2004.04.008 [11] L. Carulli, A. Lonardo, S. Lombardini, G. Marchesini and P. Loria, “Gender, Fatty Liver and GGT,” Hepatology, Vol. 44, No. 1, 2006, pp. 278-279. doi:10.1002/hep.21218 [12] B. Neal, S. MacMahon and N. Chapman, “Effects of ACE Inhibitors, Calcium Antagonists, and Other Blood Pressure-Lowering Drugs,” Lancet, Vol. 356, No. 9246, 2000, pp. 1955-1964. doi:10.1016/S0140-6736(00)03307-9 [13] G. Donati, B. Stagni, F. Piscaglia, N. Venturoli, A. M. Morselli-Labate, L. Rasciti, et al., “Increased Prevalence of Fatty Liver in Arterial Hypertensive Patients with Normal Liver Enzymes: Role of Insulin Resistance,” Gut, 2004, Vol. 53, No. 7, pp. 1020-1023. doi:10.1136/gut.2003.027086 [14] S. Yokohama, M. Yoneda, M. Haneda, S. Okamoto, M. Okada, K. Aso, et al., “Therapeutic Efficacy of an Angiotensin II Receptor Antagonist in Patients with Nonalcoholicsteatohepatitis,” Hepatology, Vol. 40, No. 5, 2004, pp. 1222-1225. doi:10.1002/hep.20420 [15] J. Stamler, O. Vaccaro, J. Neaton and D. Wentworth, “Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial,” Diabetes Care, Vol. 16, No. 2, 1993, pp. 434-444. doi:10.2337/diacare.16.2.434 [16] A. Adlerberth, A. Rosengren and L. Wilhelmsen, “Diabetes and Long-Term Risk of Mortality from Coronary and Other Causes in Middle-Aged Swedish Men. A General Population Study,” Diabetes Care, Vol. 21, No. 4, 1998, pp. 539-545. doi:10.2337/diacare.21.4.539 [17] R. de Marco, F. Locatelli, G. Zoppini, G. Verlato, E. Bonora and M. Muggeo, “Cause-Specific Mortality in Type 2 Diabetes. The Verona Diabetes Study,” Diabetes Care, Vol. 22, No. 5, 1999, pp. 756-761. doi:10.2337/diacare.22.5.756 [18] G. Marchesini, R. Marzocchi, F. Agostini and E. Bugianesim, “Nonalcoholic Fatty Liver Disease and Metabolic Syndrome,” Current Opinion in Lipidology, Vol. 16, No. 4, 2005, pp. 421-427. doi:10.1097/01.mol.0000174153.53683.f2 [19] N. Sarraf-Zadgan, G. Sadri, H. Malek-Afzali, M. Baghaei, N. Mohammadi-Fard, S. Shahrokhi, et al., “Isfahan Healthy Heart Program: A Comprehensive Integrated Community-Based Program for Cardiovascular Disease Prevention and Control,” Acta Cardiologica, Vol. 58, No. 4, 2003, pp. 309-320. doi:10.2143/AC.58.4.2005288 [20] A. Brea, D. Mosquera, E. Martín, A. Arizti, J. L. Cordero and E. Ros, “Nonalcoholic Fatty Liver Disease Is Associated with Carotid Atherosclerosis: A Case-Control Study,” Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 25, No. 5, 2005, pp. 1045-1050. doi:10.1161/01.ATV.0000160613.57985.18 [21] C. H. Tsai, T. C. Li and C. C. Lin, “Metabolic Syndrome as a Risk Factor for Nonalcoholic Fatty Liver Disease,” Southern Medical Journal, Vol. 101, No. 9, 2008, pp. 900-905. doi:10.1097/SMJ.0b013e31817e8af9 [22] G. N. Ioannou, N. S. Weiss, E. J. Boyko, D. Mozaffarian and S. P. Lee, “Elevated Serum Alanine Aminotransferase Activity and Calculated Risk of Coronary Heart Disease in the United States,” Hepatology, Vol. 43, No. 5, 2006, pp. 1145-1151. doi:10.1002/hep.21171 [23] A. Ugur, T. Sedat, B. Serhat, T. Yusuf, K. Tarkan and C. Atiye, “Association between Nonalcoholic Fatty Liver Disease and Coronary Artery Disease,” Coronary Artery Disease, Vol. 18, No. 6, 2007, pp. 433-436. doi:10.1097/MCA.0b013e3282583c0d [24] L. Pacifico, V. Cantisani, P. Ricci, J. F. Osborn, E. Schiavo, C. Anania, et al., “Nonalcoholic Fatty Liver Disease and Carotid Atherosclerosis in Children,” Pediatric Research, Vol. 63, No. 4, 2008, pp. 423-427. doi:10.1203/PDR.0b013e318165b8e7 [25] I. S. Okosun, K. M. Chandra, A. Boev, J. M. Boltri, S. T. Choi, D. C. Parish, et al., “Abdominal Adiposity in US Adults: Prevalence and Trends, 1960-2000,” Preventive Medicine, Vol. 39, No. 1, 2004, pp. 197-206. doi:10.1016/j.ypmed.2004.01.023 [26] Y. Lin, H. Lo and J. Chen, “Sonographic Fatty Liver, Overweight and Ischemic Heart Disease,” World Journal of Gastroenterology, Vol. 11, No. 31, 2005, pp. 4838-4842. [27] J. E. Bartlett, J. W. Kotrlik and C. C. Higgins, “Organizational Research: Determining Appropriate Sample Size for Survey Research,” Information Technology, Learning, and Performance Journal, Vol. 19, No. 1, 2001, pp. 43- 50. [28] S. Y. Choi, D. Kim, H. J. Kim, J. H. Kang, S. J. Chung, M. J. Park, et al., “The Relation between Non-Alcoholic Fatty Liver Disease and the Risk of Coronary Heartdisease in Koreans,” The American Journal of Gastroenterology, Vol. 104, No. 8, 2009, pp. 1953-1960. doi:10.1038/ajg.2009.238 [29] G. Targher, F. Marra and G. Marchesini, “Increased Risk of Cardiovascular Disease in Non-Alcoholic Fatty Liver Disease: Causal Effect or Epiphenomenon?” Diabetologia, Vol. 51, No. 11, 2008, pp. 1947-1953. doi:10.1007/s00125-008-1135-4 [30] A. Gastaldelli, M. Kozakova, K. Hojlund, A. Flyvbjerg, A. Favuzzi, A. Mitrakou, et al., “Fatty Liver Is Associated with Insulin Resistance, Risk of Coronary Heart Disease, and Early Atherosclerosis in a Large European Population,” Hepatology, Vol. 49, No. 5, 2009, pp. 1537-1544. doi:10.1002/hep.22845 [31] C. Matteoni, Z. Younossi, T. Gramlich, N. Boparai, Y. Liu and A. McCullough, “Nonalcoholic Fatty Liver Disease: A Spectrum of Clinical and Pathological Severity,” Gastroenterology, Vol. 116, No. 6, 1999, pp. 1413-1419. doi:10.1016/S0016-5085(99)70506-8 [32] G. Targher, L. Bertolini, R. Padovani, F. Poli, L. Scala, L. Zenari, et al., “Non-Alcoholic Fatty Liver Disease Is Associated with Carotid Artery Wall Thickness in Diet- Controlled Type 2 Diabetic Patients,” Journal of Endocrinological Investigation, Vol. 29, No. 1, 2006, pp. 55-60. [33] M. Hamaguchi, T. Kojima, N. Takeda, C. Nagata, J. Takeda, H. Sarui, et al., “Nonalcoholic Fatty Liver Disease Is a Novel Predictor of Cardiovascular Disease,” World Journal of Gastroenterology, Vol. 13, No. 10, 2007, pp. 1579-1584. [34] M. Ahmed and C. Byrne, “Obstructive Sleep Apnea Syndrome and Fatty Liver: Association or Causal Link?” World Journal of Gastroenterology, Vol. 16, No. 34, 2010, pp. 4243-4252. doi:10.3748/wjg.v16.i34.4243 [35] E. Bugianesi, A. McCullough and G. Marchesini, “Insulin Resistance: A Metabolic Pathway to Chronic Liver Disease,” Hepatology, Vol. 42, No. 5, 2005, pp. 987-1000. doi:10.1002/hep.20920 [36] G. Targher, L. Bertolini, R. Padovani, S. Rodella, G. Zop- pini, L. Zenari, et al., “Relations between Carotid Artery Wall Thickness and Liver Histology in Subjects with Nonalcoholic Fatty Liver Disease,” Diabetes Care, Vol. 29, No. 6, 2006, pp. 1325-1330. doi:10.2337/dc06-0135