Non-alcoholic fatty liver disease is not independent risk factor for cardiovascular disease event: A cohort study

World J Hepatol. 2020 Jun 27;12(6):323-331. doi: 10.4254/wjh.v12.i6.323.

Abstract

Background: There are no consistent results between previous studies for an independent association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) events.

Aim: To determine if there is an independent association between NAFLD and CVD events.

Methods: In the present study, valid outcome data of 4808 subjects were available for phase 2 of our cohort study. These subjects had been followed up for seven years from phase 1, beginning in 2009-2010 to phase 2 during 2016-2017. Simple and multiple Cox proportional models were used to determine the association between NAFLD in the primary phase of the cohort and subsequent fatal and non-fatal CVD events during follow-up.

Results: The incidence of non-fatal CVD events in males with NAFLD was significantly higher (P = 0.004) than in males without NAFLD. A positive association was demonstrated between NAFLD and non-fatal CVD events in males (Hazard ratio = 1.606; 95%CI: 1.166-2.212; P = 0.004) by the simple Cox proportional hazard model, but no independent association was detected between these in the multiple Cox models.

Conclusion: No independent association was detected between NAFLD and CVD. It is likely that diabetes mellitus and age may be the principle mediators in this regard.

Keywords: Cardiovascular disease; Cohort; Follow up; Non-alcoholic fatty liver disease; Risk factor; Type 2 diabetes mellitus.