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Fatty liver, insulin resistance and obesity: relationships with increase in coronary artery calcium over time

Fatty liver, insulin resistance and obesity: relationships with increase in coronary artery calcium over time
Fatty liver, insulin resistance and obesity: relationships with increase in coronary artery calcium over time
Background: Non alcoholic fatty liver disease (NAFLD), insulin resistance (IR) and obesity frequently co-exist with type 2 diabetes but it is uncertain whether these risk factors for vascular disease contribute to a change in at herosclerosis over time, independently of diabetes status. We tested whether the combination of fatty liver, IR and obesity was associated with an increase in coronary artery calcium (CAC) score over time, independently of diabetes status, other cardiovascular risk factors and medications.

Methods: Data were analysed from a South Korean occupational cohort of 2175 people. The outcome was increase in cardiac computed tomography (CT) CAC score between baseline and follow up. IR was defined by HOMA-IR?75th centile and fatty liver by ultrasound. Hazard ratios (HR) [95% confidence intervals (CIs)] were estimated using Cox proportional hazards regression.

Results: There were 592 (27.2%) participants in whom CAC score increased from baseline (mean±SD age at baseline 44.8±5.5 years) and 1583 subjects in whom CAC did not change or improved during follow up (mean±SD age 41.6± 5.6 years). Diabetes, HOMA-IR, fatty liver and obesity prevalence were all higher (all p<0.001), in participants in whom CAC score increased from baseline. Adjusting for diabetes and potential confounders, the combination of IR, obesity and fatty liver was independently associated with increase in CAC score over time [(HR 2.46, (95%CIs 1.50,4.03)].

Conclusions: The combination of fatty liver, IR and obesity is associated with progression of atherosclerosis over time independently of diabetes, cardiovascular risk factors, and all medications for cardiovascular disease and diabetes
0160-9289
321-328
Sung, K.C.
be77bd09-0bba-4fcf-8096-c0049ce4e2ce
Ryu, S.
c2eb4ab3-d9ea-49c4-846c-49afe538a376
Lee, JY
765b3bde-5035-4fb1-8900-595189e04d45
Lee, SH
72c8febe-66c8-459d-8b32-78f2eea38675
Cheong, ES
0644a09c-2201-42f3-b640-98235a1b17d6
Wild, SH
732c2252-2cfe-4c26-b454-61be0eb8c968
Byrne, CD
1370b997-cead-4229-83a7-53301ed2a43c
Sung, K.C.
be77bd09-0bba-4fcf-8096-c0049ce4e2ce
Ryu, S.
c2eb4ab3-d9ea-49c4-846c-49afe538a376
Lee, JY
765b3bde-5035-4fb1-8900-595189e04d45
Lee, SH
72c8febe-66c8-459d-8b32-78f2eea38675
Cheong, ES
0644a09c-2201-42f3-b640-98235a1b17d6
Wild, SH
732c2252-2cfe-4c26-b454-61be0eb8c968
Byrne, CD
1370b997-cead-4229-83a7-53301ed2a43c

Sung, K.C., Ryu, S., Lee, JY, Lee, SH, Cheong, ES, Wild, SH and Byrne, CD (2016) Fatty liver, insulin resistance and obesity: relationships with increase in coronary artery calcium over time. Clinical Cardiology, 39 (6), 321-328. (doi:10.1002/clc.22529). (PMID:26997000)

Record type: Article

Abstract

Background: Non alcoholic fatty liver disease (NAFLD), insulin resistance (IR) and obesity frequently co-exist with type 2 diabetes but it is uncertain whether these risk factors for vascular disease contribute to a change in at herosclerosis over time, independently of diabetes status. We tested whether the combination of fatty liver, IR and obesity was associated with an increase in coronary artery calcium (CAC) score over time, independently of diabetes status, other cardiovascular risk factors and medications.

Methods: Data were analysed from a South Korean occupational cohort of 2175 people. The outcome was increase in cardiac computed tomography (CT) CAC score between baseline and follow up. IR was defined by HOMA-IR?75th centile and fatty liver by ultrasound. Hazard ratios (HR) [95% confidence intervals (CIs)] were estimated using Cox proportional hazards regression.

Results: There were 592 (27.2%) participants in whom CAC score increased from baseline (mean±SD age at baseline 44.8±5.5 years) and 1583 subjects in whom CAC did not change or improved during follow up (mean±SD age 41.6± 5.6 years). Diabetes, HOMA-IR, fatty liver and obesity prevalence were all higher (all p<0.001), in participants in whom CAC score increased from baseline. Adjusting for diabetes and potential confounders, the combination of IR, obesity and fatty liver was independently associated with increase in CAC score over time [(HR 2.46, (95%CIs 1.50,4.03)].

Conclusions: The combination of fatty liver, IR and obesity is associated with progression of atherosclerosis over time independently of diabetes, cardiovascular risk factors, and all medications for cardiovascular disease and diabetes

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Accepted/In Press date: February 2016
e-pub ahead of print date: 21 March 2016
Published date: June 2016
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 386987
URI: http://eprints.soton.ac.uk/id/eprint/386987
ISSN: 0160-9289
PURE UUID: fcac8f4b-c38b-4183-af40-4360d4b00a28
ORCID for CD Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 05 Feb 2016 16:14
Last modified: 17 Dec 2019 06:55

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