Cardiovascular disease in nonalcoholic fatty liver disease was found to be associated with traditional cardiovascular disease risk factors, as well as nontraditional factors like increased MELD score and lower sodium levels, according to published findings.

Using data from the Partners Healthcare electronic medical records database, the researchers performed a cross-sectional study of 8,409 patients with NAFLD, evaluating those with and without cardiovascular disease (CVD) to determine unique CVD risk factors.

“We [hypothesized] that the same drivers of progressive NAFLD, systemic inflammation, lipid oxidation and endothelial dysfunction, may also drive the development of CVD, making CVD increasingly prevalent as NAFLD progresses and associated with markers of liver disease progression,” Kathleen E. Corey, MD, MPH, MMSc, assistant professor of medicine, Harvard Medical School, and director of the Massachusetts General Hospital Fatty Liver Clinic, and colleagues wrote.

Of all the patients, 3,243 showed evidence of CVD. These patients tended to be older compared with patients with NAFLD without CVD (P < .0001), as well as male (P = .0006) and Caucasian (P < .0001).

Univariate analysis showed traditional risk factors for CVD were more prevalent in patients with NAFLD and CVD compared with those with NAFLD alone. In addition, several nontraditional risk factors for CVD and NAFLD, such as decreased albumin and platelet count, were associated with CVD and NAFLD compared with patients with NAFLD alone (P < .0001 for both).

After adjusting for gender, ethnicity, diabetes and other factors, multivariate analysis showed CVD in NAFLD patients to be associated with traditional CVD risk factors such as family history of CVD (OR = 4.25; 95% CI, 1.84-9.83), hypertension (OR = 2.54; 95% CI, 1.42-4.58), renal failure (OR = 1.59; 95% CI, 1.01-2.49) and age (OR = 1.05; 95% CI, 1.03-1.06).

Further analysis showed nontraditional CVD risk factors such as albumin, sodium and MELD score to be associated with CVD.

Increased MELD score was associated with an increased risk for CVD (OR = 1.1; 95% CI, 1.06-1.14), whereas albumin (OR = 0.52; 95% CI, 0.44-0.63) and sodium (OR = 0.96; 95% CI, 0.93-0.99) were inversely associated with CVD, according to multivariate analysis.

The researchers concluded: “These findings suggest that the drivers of NAFLD may also promote CVD development and progression.” – by Melinda Stevens