Patients with nonalcoholic fatty liver disease have an increased risk of heart disease

May 02, 2006

A new study on the relationship between nonalcoholic fatty liver disease (NAFLD) and heart disease found that patients with an elevated level of the enzyme associated with NAFLD had an increased risk of coronary heart disease, which appears to be related to insulin resistance, obesity and central fat distribution.

The results of this study appear in the May 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at

NAFLD, a condition affecting up to 30 percent of the adult U.S. population, is strongly associated with predictors of heart disease, such as high cholesterol, insulin resistance, obesity and central fat distribution. Patients with NAFLD are therefore expected to have an increased risk of heart disease. However, whether or not this is the case has not been well studied to date.

Led by George Ioannou, M.D., M.S. of the Veterans Affairs Puget Sound Health Care System in Seattle, WA, researchers analyzed whether patients with suspected NAFLD who did not have viral hepatitis or consume excessive amounts of alcohol had an elevated risk of heart disease. The basis used to calculate heart disease risk was the Framingham Risk Score, a scale that takes into account age, cholesterol, blood pressure, diabetes, and smoking to predict the 10-year risk of developing heart disease. The presence of NAFLD was determined by measuring levels of alanine aminotransferase (ALT), an enzyme present in liver and heart cells that is elevated when these organs are damaged. Among the study's 7,526 patients without viral hepatitis or excessive alcohol use, 267 patients had elevated ALT activity. Researchers also analyzed 855 patients who had hepatitis or increased alcohol consumption (two potential causes of chronic liver disease) in order to rule out the possibility that liver inflammation (which is also indicated by elevated ALT) and not NAFLD might affect heart disease risk.

The results showed that patients with elevated ALT who did not have hepatitis or excessive alcohol intake had an increased risk of heart disease, particularly among women. Patients who had hepatitis or consumed excessive amounts of alcohol and were not obese did not have this increased risk. "Given that elevated serum ALT in the absence of viral hepatitis or excessive alcohol consumption is most commonly due to NAFLD in the U.S., our results suggest that NAFLD is associated with an increased risk of coronary heart disease," the authors state. They also evaluated whether there was a threshold level of ALT above which the risk of heart disease was elevated and found that it was higher in men than in women.

Although the association between NAFLD (or elevated ALT) and predictors of heart disease has been established and the link between NAFLD and increased risk of heart disease has been suggested, the current study is the first analysis that demonstrates and quantifies this risk in the U.S. population, for men and women separately, and for different thresholds of ALT. "Most of this excess calculated risk of coronary heart disease in persons with elevated ALT appears to be related to the increased prevalence of insulin resistance, obesity, and central fat distribution which are thought to be the predisposing conditions of NAFLD," the authors conclude.
Article: "Elevated Serum Alanine Aminotransferase Activity and Calculated Risk of Coronary Heart Disease in the United States," George Ioannou, Noel Weiss, Edward Boyko, Dariush Mozaffarian, Sum Lee, Hepatology; May 2006 (DOI: 10.1002/hep.21171).


Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal)

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to