The Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Disease Outcomes

Abstract

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AGA Clinical Practice Update on Screening and Surveillance for Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease: Expert Review

“…Dyslipidemia (high serum triglyceride, decreased serum high-density lipoprotein levels, increased serum low-density lipoprotein) is also a well-established risk factor for NAFLD, which has an estimated overall prevalence of 53.8% of patients attending lipid clinics, and 78.0% among the subgroup with the highest total cholesterol to high-density lipoprotein cholesterol or triglyceride to high-density lipoprotein cholesterol ratios. 65 Among patients with NAFLD, dyslipidemia is associated with an increased risk of NASH and cardiovascular disease, [65][66][67] but has not been demonstrated to represent an independent risk factor for liverrelated mortality. 66,67 Recent data suggest a possible association between hyperlipidemia and HCC incidence in noncirrhotic patients with biopsy-proven NASH.…”

“…65 Among patients with NAFLD, dyslipidemia is associated with an increased risk of NASH and cardiovascular disease, [65][66][67] but has not been demonstrated to represent an independent risk factor for liverrelated mortality. 66,67 Recent data suggest a possible association between hyperlipidemia and HCC incidence in noncirrhotic patients with biopsy-proven NASH. 68 Dyslipidemia is routinely treated with antilipidemic agents, such as statins, although limited data are available to clarify the impact of statins on clinical outcomes in patients with NAFLD.…”

Association between remnant lipoprotein cholesterol levels and non-alcoholic fatty liver disease in adolescents

“…4,12,13 Adults with NAFLD have a 2-fold increased risk of coronary artery disease and have increased cardiovascular events. 14 Individuals with NAFLD also have a lipid profile referred to as the 'atherogenic lipid triad', typified by increased levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), and low HDL-C. 15 A longitudinal community follow-up study in the USA showed an increasing incidence of NAFLD, particularly in adolescents and young adults, and an association between NAFLD and increased cardiovascular events over 10 years. 16 Remnant lipoprotein cholesterol (RLP-C), the cholesterol contained in very-low-density lipoprotein (VLDL), was associated with incident coronary heart disease in adults in the Jackson Heart and Framingham Offspring Cohort Studies in the USA.…”

Evaluation and management of extrahepatic manifestations of nonalcoholic fatty liver disease

“…(12,17,18) Thus, aggressive screening for metabolic and CVD risk factors as well as risk factor modification are essential strategies to reduce the risk of CVD mortality. (19) The European Association for the Study of the Liver (EASL) and American Association for the Study of the Liver Disease (AASLD) guidelines recommend screening for metabolic risk factors in patients with NAFLD; however, at this time there is no role for screening asymptomatic individuals with NAFLD for CVD. (1, 20) An algorithm to screen and manage metabolic risk factors, including obesity, diabetes, dyslipidemia, and hypertension, in patients with NAFLD, has been proposed by Wong and Lim.…”