Metabolic dysfunction-associated fatty liver disease is associated with the presence of coronary atherosclerotic plaques and plaque burden

Xueli Cai; Xin Su; Yanli Zhang; Suying Wang; Yuesong Pan; Aoming Jin; Jing Jing; Jingping Sun; Lerong Mei; Xia Meng; Shan Li; Zhang Xia; Yuhao Li; Zijun Liu; Yongjun Wang; Yan He; Tiemin Wei

doi:10.1016/j.hjc.2024.06.002

Metabolic dysfunction-associated fatty liver disease is associated with the presence of coronary atherosclerotic plaques and plaque burden

Hellenic J Cardiol. 2024 Jun 11:S1109-9666(24)00126-X. doi: 10.1016/j.hjc.2024.06.002. Online ahead of print.

Authors

Xueli Cai¹, Xin Su², Yanli Zhang³, Suying Wang⁴, Yuesong Pan³, Aoming Jin³, Jing Jing³, Jingping Sun¹, Lerong Mei⁴, Xia Meng³, Shan Li⁴, Zhang Xia², Yuhao Li², Zijun Liu⁵, Yongjun Wang³, Yan He⁶, Tiemin Wei⁷

Affiliations

¹ Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China.
² Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
³ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Cerebrovascular Research Lab, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China.
⁵ School of Basic Medical Sciences, Capital Medical University, Beijing, China.
⁶ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. Electronic address: yanhe118@sina.com.
⁷ Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China. Electronic address: lswtm@sina.com.

PMID: 38871181
DOI: 10.1016/j.hjc.2024.06.002

Abstract

Objective: Atherosclerosis is closely related to cardiovascular disease risk. The present study aims to evaluate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and the presence of coronary atherosclerotic plaques and plaques burden, as detected by computed tomography angiography (CTA), and further test the screening value of MAFLD on the presence of coronary atherosclerotic plaques and plaques burden.

Methods: We used data from the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events study, a community-based cohort. Hepatic steatosis was assessed using the fatty liver index. Coronary atherosclerotic plaques and burden were detected by CTA. The association of MAFLD with the presence of coronary atherosclerotic plaques and burden was assessed by binary and ordinal logistic regression models, respectively.

Results: Among the 3029 participants (mean age 61.2 ± 6.7 years), 47.9% (1452) presented with MAFLD. MAFLD was associated with an increased odds of the presence of coronary atherosclerotic plaques (OR, 1.27; 95% CI: 1.03-1.56), segment involvement score [cOR (common odds ratio), 1.25; 95% CI, 1.03-1.51], and segment stenosis score (cOR, 1.29; 95% CI, 1.06-1.57). Participants with severe fibrosis or diagnosed as DM-MAFLD subtypes had with higher odds for the presence of coronary atherosclerotic plaques and plaques burden. In addition, MAFLD demonstrated a higher sensitivity for detecting the presence of coronary atherosclerotic plaques and plaque burden (54%-64%) than conventional CVD risk factors (such as diabetes, obesity, and dyslipidemia).

Conclusion: MAFLD is associated with higher odds of having coronary atherosclerotic plaques and plaque burden. Moreover, MAFLD may offer better screening potential for coronary atherosclerosis than established CVD risk factors.

Keywords: Computed tomography angiography; Coronary atherosclerosis plaques; Metabolic dysfunction–associated fatty liver disease; Screening.