Increased liver fibrosis assessed by magnetic resonance elastography among patients with nonalcoholic fatty liver disease and type 2 diabetes correlated with a higher risk for cardiovascular risk, according to published data.
“Accurately assessing [cardiovascular disease] risk in NAFLD patients is critical to improving clinical outcomes,” Neeraj Mangla, MD, from the NAFLD Research Center in La Jolla, California, and colleagues wrote. “Utilization of liver stiffness measurements to non-invasively assess for liver fibrosis is broadening and magnetic resonance elastography (MRE) is the most accurate modality in NAFLD.”
To determine if MRE-assessed liver fibrosis stage is associated with CVD risk, Mangla and colleagues evaluated 96 adult patients with type 2 diabetes, 63 of whom had NAFLD.
Median coronary artery calcium increase was 824 among patients with advanced fibrosis compared with 14 in mild fibrosis and 1 in those without fibrosis (P = .009). Similarly, in a subanalysis of those with NAFLD, median coronary artery calcium was 522 in those with advanced fibrosis, 10 in mild fibrosis and 0 in those with no fibrosis (P = .041).
Patients with advanced fibrosis (OR = 14; 95% CI, 1.47-133.24) and those with NAFLD and advanced fibrosis (OR = 11.72; 95% CI, 1.11-123.96) had a higher risk for coronary artery calcium levels higher than 300 compared with those without advanced fibrosis.
“Our findings support prior studies suggesting that NAFLD may be an independent risk factor for CVD risk and provides additional evidence that the severity of fibrosis may be associated with CVD risk,” Mangla and colleagues wrote. “Although patients did not receive liver biopsy, MRE is the most accurate noninvasive marker of liver fibrosis and MRI-PDFF may be more accurate than liver biopsy for quantifying hepatic steatosis.” – by Talitha Bennett
Disclosure: The authors report no relevant financial disclosures.