Non-Alcoholic Fatty Liver Disease as a Coronary Heart Disease Severity Predictor

Background and Aim: Association of non-alcoholic fatty liver disease (NAFLD) and liver related mortality is well-known; however; its cardiovascular risk remains questionable. The aim of this work was to highlight the association between NAFLD and the severity of coronary heart disease. Method: The study was conducted between July and December 2019 at Qena university hospital, Qena, Egypt on patients who were scheduled for coronary angiography. Liver steatosis was diagnosed using FibroScan and the severity of coronary artery occlusion was assessed by Gensini score calculation. Statistical analysis was done to study the correlation between liver steatosis and angiography findings. Result: A total of 100 patients were included, mean age 48 years (±8 SD). Correlation between coronary angiography and the baseline variables revealed statistically significant positive correlation between Gensini score and ALT (p = 0.002), FBS (p < 0.001), steatosis (p < 0.001) and diabetes (p < 0.001). Also, gradual increase in the Gensini score with higher steatosis grades was noticed, medians: 10.5, 21.7, 57.6 and 102.6 in S0, S1, S2 and S3 respectively, p = 0.01. Variables that have significantly predicted higher Gensini score in univariable regression analysis were: diabetes (OR: 55.6, CI: (41 - 70)), hypertension (OR: 19, CI: (2 - 37)), F2-F4 fibrosis (OR: 33, CI: (24 - 38)) and S2-S3 steatosis (OR: 34, (23 - 40)), while in multivariable regression; the statistically significant variables were: diabetes (OR: 23, CI: (10 - 37)), hypertension (OR: 11, CI: (4.8 - 22)) and S2-S3 steatosis (OR: 24, CI: (17 - 31)). Conclusion: NAFLD is an independent cardiovascular risk predictor with statistically significant increase in Gensini score with the higher grades of NAFLD.