FLD may increase risk of atherosclerotic progression in healthy obese individuals
Despite their healthy metabolic profile, metabolically healthy obese (MHO) individuals with fatty liver disease (FLD) are at a higher risk of atherosclerotic progression, a new study shows.
The study involved 1,240 patients (mean age 54.2±7.4 years) who underwent coronary artery calcification (CAC) score measurements during routine check-ups. Those with histories of cardiovascular diseases, taking statins, with hepatocellular carcinoma and who had received liver transplants were excluded.
CAC scores were measured using coronary computed tomography angiography (CCTA) and hepatic ultrasounds. Hepatic ultrasonography was used to potentially diagnose FLD.
Of all participants, 22.7 percent (n=282) had the MHO phenotype. There were more males in the MHO group than in the MH nonobese (MHNO) group. Moreover, individuals in the MHO group had higher levels of low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG) and fasting plasma glucose (FPG).
CAC progression was observed in 25.2 percent (n=312) of participants over the median follow-up period of 2.9 (0.8 to 7.0) years. The metabolically unhealthy obese group (MUO) had the highest proportion of CAC progression (32.3 percent), followed by MHO (28.0 percent), MU nonobese (MUNO; 23.1 percent) and MHNO (19.2 percent).
MHO individuals had an increased risk of CAC progression (unadjusted odds ratio [OR], 1.63; 95 percent CI, 1.15 to 2.32) compared to MHNO individuals. After controlling for confounders, only the MUO had a significantly greater risk of CAC progression (adjusted OR, 1.71; 1.10 to 2.65).
Finally, CAC progression was significantly associated with MHO individuals with FLD at baseline (adjusted OR, 2.37; 1.34 to 4.16) relative to MHNO individuals without baseline FLD. By comparison, MHO individuals without baseline FLD showed no significant association to CAC progression (adjusted OR, 1.26; 0.71 to 2.24).