Cardiovascular risk estimation in non alcoholic fatty liver disease

Nonalcoholic fatty liver disease is rising to the growing epidemic of metabolic syndrome. Recent data suggest that this liver disease may represent a real marker of cardiovascular risk. The aim of our study was to calculate cardiovascular risk and to estimate the frequency of subclinical coronary artery disease by conducting an exercise testing.

This is a prospective study conducted over a period of one year including all patients followed for non alcoholic fatty liver disease. We realized in all patients an exercise testing and we calculated the ACC / AHA score that estimates the risk of developing atherosclerotic cardiovascular disease. This risk is considered very high if the score> 7.5.

We included 103 patients. The mean age was 52 years. The sex ratio (M/F) was 0.3. Diabetes, dyslipidemia and hypertension were present respectively in 45.6%, 48.5% and 38.8% of cases. Obesity was noted in 69.9% of our patients. Metabolic syndrome was found in 78.6% of patients. The ACC / AHA average score was 8.03 ± 9 and a score> 7.5 was noted in 35.9% of cases. The exercise testing was positive in 12 patients (11.65%). Of these, 11 underwent coronary angiography which was normal in 10 cases and showed a coronary artery infiltration without significant stenosis in only one case, and 2 patients underwent coro-scanner which was without significant anomalies. In univariate analysis, the presence of metabolic syndrome (p = 0.05), waist circumference ≥ 94 cm in men and ≥ 80 cm in women (p = 0.019), diabetes (p = 0.03) were associated with a high risk of developing cardiovascular events. In multivariate analysis, the only independent variable associated with a positive exercise testing was diabetes (OR 4.5, p = 0.03).

During non alcoholic fatty liver disease, there is an increased cardiovascular risk. It would be necessary to consider this excess risk in the surveillance of patients followed for non alcoholic liver disease to early detection of any cardiovascular disease.