World Congress at ACG2017
Simultaneous Plenary Session 1A: Liver
12 - Degree of Estimated Fibrosis in Asymptomatic Subjects With Non-Alcoholic Fatty Liver Disease Correlates With Higher Cardiovascular Risk
Monday, October 16
4:40 PM - 4:50 PM
Location: Valencia Ballroom A (Level 4)
Maria Cristina Moreno del Castillo, MD, Alain Sanchez Rodriguez, MD, Javier Jose Hernandez Buen Abad, MD, Jose Ramon Mena Ramirez, MD, Ricardo Garcia-Buen-Abad, MD, Natalie Atkinson, MD, Maria Emilia Mendizabal Rodriguez, MD, Jonathan Salazar Segovia, MD, Ignacio Garcia Juarez, MD
American British Cowdray, Medical Center, Mexico City, Distrito Federal, Mexico
Introduction: Our aim is to assess the estimated 10-year atherosclerotic cardiovascular (ASCVD) risk scores in patients with NAFLD according to the degree of estimated fibrosis by Non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS).
Methods: Cross-sectional observational study from a single center in Mexico conducted as a case control analysis in asymptomatic outpatients. NAFLD cases were defined by a positive ultrasound. Estimated 10-year ASCVD risk was calculated with the 2013 American College of Cardiology and the American Heart Association (2013 ACC/AHA) risk equation, Framingham risk score for coronary heart disease (FRS-CHD). High ASCVD risk was defined according to standardized cutoff points: for 2013 ACC/AHA (>= 7.5%) and Framingham (> =20%). NFS was stratified according to the following cut-off points into three groups with progressive degree of fibrosis (<-1.455: F0-F2, >=-1.455-≤ 0.675: indeterminate score, >0.675: F3-F4 fibrosis).
Results: We included data from 141 patients with NAFLD by ultrasound and 354 healthy controls. 62% were males, BMI of 25.9 (SD ± 3.9) Kg/m2, 45 (SD ± 11.5) years old. We previously excluded patients with significant alcohol consumption (defined by >30 gr/day in men, >20 g/day in women). NAFLD vs. controls patients had higher mean cardiovascular risk assesed by FRS and 2013 ACC/AHA with 7.1 vs 4.1%(p=0.05) and 5.7 vs 4.4% (p=0.05), respectively, additionally a selected cutoff point for FRS (=>10%) showed a strong association with NAFLD [OR = 5.05 (95% CI 2.1 – 11.9, p < 0.01)]. Global 10-year ASCVD risk was in the case group: for ACC/AHA 5.8% (CI: 95% 4.6-6.9), FRS-CHD 7.2% (CI: 95% 6.1-8.2). Higher degree of fibrosis by NFS correlated with higher FRS risk with a median of 3.5 (RIQ 1.3-7.5), 3.9 (RIQ 2.0-5.7), 8.7 (RIQ 5.3-13.1), for NFS cut-off points F0-F2, indeterminate score, F3-F4 fibrosis, respectively (p < 0.01). High cardiovascular risk estimated for FRS was strongly associated with F3-F4 fibrosis [OR = 9.8 (95% CI 1.17 – 81, p=0.011)]. Total NFS and FRS scores showed correlation with a spearman’s Rho of 0.49, (p < 0.001).
Discussion: NAFLD patients have higher ASCVD risk than healthy subjects. Higher estimated fibrosis by NAFLD score correlated with higher 10-year ASCVD risk in asymptomatic patients with ultrasonographic fatty liver disease. Presence of higher estimated NFS in fatty liver disease should prompt cardiovascular risk assessment and intervention.
Supported by Industry Grant: No
Comparison between estimated 10-year risk by Framingham score and NAFLD fibrosis score in patients with ultrasonographic fatty liver disease (n=141).
Citation: . DEGREE OF ESTIMATED FIBROSIS IN ASYMPTOMATIC SUBJECTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE CORRELATES WITH HIGHER CARDIOVASCULAR RISK. Program No. 12. World Congress of Gastroenterology at ACG2017 Meeting Abstracts. Orlando, FL: American College of Gastroenterology.