Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease: A Bidirectional Association Based on Endothelial Dysfunction
Abstract
:1. Introduction
2. Epidemiology and the Consensus of NAFLD Terminology
3. Metabolic-Associated Fatty Liver Disease (MAFLD) and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
4. NAFLD and Coronary Artery Disease
5. Shared Risk Factors of CAD and NAFLD
6. Pathophysiological Mechanisms and Association of CAD and NAFLD
7. The Role of the Endothelium in Atherosclerosis
8. Endothelial Dysfunction and NAFLD
9. Systemic Inflammation and NAFLD
10. Plaque Formation/Instability and NAFLD
11. Platelet-Activating Factor as the Connecting Link between NAFLD and CAD
12. Gut Microbiota and NAFLD
13. Lipid Metabolism Dysregulation and NAFLD
14. Insulin Resistance and NAFLD
15. Studies Associating CAD and NAFLD
16. Genetic Associations between NAFLD and CAD
17. Clinical Implications
18. Optimizing Medical Options
19. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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First Author | Year of Publication | Number of Patients | NAFLD and CAD Diagnostic Method | Results |
---|---|---|---|---|
Thévenot [68] | 2022 | 189 | Non-invasive fibrosis tests, Fibroscan and coronary angiography | 5% of patients with documented CAD had NAFLD. |
Hsu [33] | 2021 | 1502 | Abdominal ultrasonography and cardiac computed tomography | NAFLD severity is associated with coronary artery atherosclerosis burden, and steatosis severity correlated with the risk of presence of coronary plaques. |
Fiorentino [69] | 2020 | 1254 | Abdominal ultrasonography and coronary angiography | NAFLD independently associated with an increased risk of having CVD in patients with glucose disturbances. |
Langroudi [70] | 2018 | 264 | Abdominal ultrasonography and cardiac computed tomography | NAFLD may NOT be associated with atherosclerosis of coronary arteries and its severity in non-diabetic patients. |
Sinn [67] | 2017 | 4731 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was significantly associated with the development of CAD. |
Ishiba [71] | 2016 | 698 | Abdominal and cardiac computed tomography | The progression of arteriosclerosis and that of liver fibrosis may be associated in NAFLD patients. |
Osawa [72] | 2015 | 414 | Abdominal and cardiac computed tomography | Diagnosis of NAFLD may be important when assessing the risk of CAD. |
Wong [73] | 2015 | 612 | Abdominal ultrasonography and coronary angiography | NAFLD is associated with CAD and need for coronary intervention, but not increased mortality or cardiovascular complications. |
Idilman [74] | 2015 | 273 | Abdominal and cardiac computed tomography | NAFLD is associated with significant CAD in type 2 diabetic patients. |
Puchner [75] | 2014 | 445 | Abdominal and cardiac computed tomography | NAFLD is associated with advanced high-risk coronary plaque. |
Wong [76] | 2011 | 612 | Abdominal ultrasonography and coronary angiography | NAFLD is associated with CAD independently of other metabolic factors. |
Sun [77] | 2011 | 542 | Abdominal and cardiac computed tomography | NAFLD is associated with high severity of CAD, requiring consciousness in patients with abdominal obesity. |
Açikel [78] | 2009 | 355 | Abdominal ultrasonography and coronary angiography | NAFLD is associated with the presence of CAD and severity of coronary atherosclerosis. |
First Author | Year of Publication | Number of Patients | NAFLD and CAD Diagnostic Method | Results |
---|---|---|---|---|
Carter [79] | 2022 | 1726 | Abdominal and cardiac computed tomography | Hepatosteatosis was associated with an increased prevalence of CAD. |
Ichikawa [80] | 2022 | 1148 | Abdominal and cardiac computed tomography | Stable CAD and concurrent evaluation of NAFLD enables more accurate detection of patients at higher risk of MACEs. |
Chen [65] | 2021 | 545 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was associated with the presence of significant CAD. |
Ichikawa [81] | 2021 | 529 | Abdominal and cardiac computed tomography | NAFLD in addition to CAD and risk factors, could be useful for identifying diabetic patients at risk of MACEs. |
Meyersohn [62] | 2021 | 3756 | Abdominal and cardiac computed tomography | Hepatic steatosis is associated with MACEs independently of other cardiovascular risk factors or extent of coronary artery disease. Strategies to reduce steatosis might reduce risk of MACEs. |
Saraya [82] | 2021 | 800 | Abdominal and cardiac computed tomography | NAFLD is associated with CAD. |
Bae [83] | 2020 | 3693 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was associated with CAD. |
Koo [84] | 2020 | 719 | Abdominal and cardiac computed tomography | The association between NAFLD and arterial calcification is mainly mediated by conventional risk factors. |
Oni [85] | 2019 | 4123 | Abdominal and cardiac computed tomography | NAFLD is associated with carotid atherosclerosis and CAD. |
Pais [86] | 2019 | 2617 | Abdominal ultrasonography and cardiac computed tomography | Steatosis is associated with carotid and coronary, but not femoral atherosclerosis, and with cardiovascular mortality risk. |
Sinn [67] | 2019 | 111,492 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was associated with the development of CAD independent of cardiovascular and metabolic risk factors. |
Lee [87] | 2018 | 5121 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was associated with non-calcified plaque. |
Kim [88] | 2017 | 1575 | Abdominal and cardiac computed tomography | NAFLD and systemic inflammation increases the risk of CAD over 4 years. |
Wu [89] | 2017 | 2345 | Abdominal ultrasonography and cardiac computed tomography | NAFLD and CAD associations were significant in female but not in male. |
Kim [90] | 2016 | 1472 | Abdominal ultrasonography and cardiac computed tomography | Epicardial fat volume and NAFLD are associated with the presence of metabolic syndrome. |
Park [91] | 2016 | 1732 | Abdominal ultrasonography and cardiac computed tomography | NAFLD was associated with the early development of CAD, but not the progression. |
Mellinger [92] | 2015 | 3529 | Abdominal and cardiac computed tomography | Association of hepatic steatosis with subclinical CVD. |
Al Rifai [93] | 2015 | 3976 | Abdominal and cardiac computed tomography | NAFLD is associated with increased inflammation and CAD, independent of traditional risk factors, obesity, and metabolic syndrome. |
Lee [94] | 2015 | 10,063 | Abdominal ultrasonography and cardiac computed tomography | NAFLD is associated with CAD. |
VanWagner [95] | 2014 | 2424 | Abdominal and cardiac computed tomography | Obesity attenuates the relationship between NAFLD and subclinical atherosclerosis. |
Juarez-Rojas [96] | 2013 | 765 | Abdominal and cardiac computed tomography | NAFLD increases the association of metabolic syndrome with type 2 diabetes and subclinical atherosclerosis. |
Sung [97] | 2013 | 7371 | Abdominal ultrasonography and cardiac computed tomography | Both NAFLD and brachial-ankle pulse wave velocity are associated with CAD. |
Kim [59] | 2012 | 4023 | Abdominal and cardiac computed tomography | NAFLD patients are at increased risk for CAD. |
Sung [98] | 2012 | 3784 | Abdominal and cardiac computed tomography | NAFLD and insulin resistance are both associated with CAD. |
Lin [99] | 2005 | 2088 | Abdominal ultrasonography and digital electrocardiography | Synergistic effect between NAFLD and overweight for developing ischemic heart disease. |
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Ktenopoulos, N.; Sagris, M.; Gerogianni, M.; Pamporis, K.; Apostolos, A.; Balampanis, K.; Tsioufis, K.; Toutouzas, K.; Tousoulis, D. Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease: A Bidirectional Association Based on Endothelial Dysfunction. Int. J. Mol. Sci. 2024, 25, 10595. https://doi.org/10.3390/ijms251910595
Ktenopoulos N, Sagris M, Gerogianni M, Pamporis K, Apostolos A, Balampanis K, Tsioufis K, Toutouzas K, Tousoulis D. Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease: A Bidirectional Association Based on Endothelial Dysfunction. International Journal of Molecular Sciences. 2024; 25(19):10595. https://doi.org/10.3390/ijms251910595
Chicago/Turabian StyleKtenopoulos, Nikolaos, Marios Sagris, Maria Gerogianni, Konstantinos Pamporis, Anastasios Apostolos, Konstantinos Balampanis, Konstantinos Tsioufis, Konstantinos Toutouzas, and Dimitris Tousoulis. 2024. "Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease: A Bidirectional Association Based on Endothelial Dysfunction" International Journal of Molecular Sciences 25, no. 19: 10595. https://doi.org/10.3390/ijms251910595