Mixed
Non-alcoholic fatty liver disease (NAFLD) is independently associated with a significantly increased risk of major cardiovascular disease (CVD) events, including fatal and non-fatal outcomes, with risk magnitude increasing with the severity of liver fibrosis.
If you have been diagnosed with NAFLD, you must undergo regular cardiovascular screening, regardless of your cholesterol or blood pressure levels. The presence of fatty liver, especially if fibrosis is present, independently increases your risk of heart attacks and stroke. Aggressive management of cardiometabolic risk factors is essential.
This meta-analysis concluded that NAFLD (diagnosed by liver biopsy or imaging methods) conferred an OR of 1.64 for fatal and/or non-fatal CVD events... Furthermore, risk of incident CVD events appeared to increase further with greater severity of NAFLD... and remained statistically significant in those studies where analysis was fully adjusted for established CVD risk factors.
Why this rating
Based on large cohort studies and a comprehensive meta-analysis of 16 observational studies with over 34,000 individuals, though causality requires RCTs.
Source
NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications
Giovanni Targher et al. · Gut · 2020
DOI 10.1136/gutjnl-2020-320622
More from this paper
- Low-grade systemic inflammation, driven by hepatic cytokine production, visceral adipose tissue, and gut microbiota metabolites (like TMAO), is a key pathophysiological mechanism linking NAFLD to cardiovascular disease and arrhythmias.Moderate
- Treatment of NAFLD with specific pharmacological agents, particularly pioglitazone and GLP-1 receptor agonists, can improve liver histology and potentially reduce cardiovascular risk, although large RCTs focusing on CVD outcomes are still needed.Moderate
Related findings · Mixed
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