BACKGROUND In patients with non-alcoholic fatty liver disease (NAFLD) cardiovascular diseases are more often the cause of death than the liver disease itself. However, the prevalence of atherosclerotic manifestations in individuals with NAFLD is still uncertain. This study aimed to explore the association between NAFLD and coronary artery calcification (CAC) in a Central European population. METHODS A total of 1,743 participants from the Paracelsus 10,000 study were included. The participants underwent CAC scoring and were assessed for fatty liver index (FLI), fibrosing non-alcoholic steatohepatitis Index (FNI) and fibrosis-4 index (FIB-4 score), which are indicators for steatosis and fibrosis. Multivariable logistic regression models were calculated. RESULTS Results revealed an association between liver steatosis/fibrosis and CAC. A FLI > 60 was associated with higher odds of NAFLD (OR 3.38, 95% CI: 2.61-4.39, p < 0.01) and increased prevalence of CAC-Score >300 compared to FLI <30 (9% vs. 3%, p < 0.01), even after adjusting for traditional cardiometabolic risk factors. While the crude odds ratios of the FIB-4 scores ≥ 1.3 and FNI score were significantly associated with increased odds of CAC, they became non-significant after adjusting for age, sex, and MetS. CONCLUSION This study reveals a significant association between NAFLD and CAC. The findings suggest that assessing liver fat and fibrosis could enhance assessment of cardiovascular risk, but further research is needed to determine whether hepatic fat plays an independent role in the development of atherosclerosis and whether targeting liver steatosis can mitigate vascular risk.

中文翻译：

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非酒精性脂肪肝患者亚临床心血管疾病的患病率：Paracelsus 10.000 队列研究分析。

背景技术对于非酒精性脂肪性肝病（NAFLD）患者来说，心血管疾病比肝病本身更常成为死亡原因。然而，NAFLD 个体中动脉粥样硬化表现的患病率仍不确定。本研究旨在探讨中欧人群中 NAFLD 与冠状动脉钙化 (CAC) 之间的关联。方法 Paracelsus 10,000 研究中总共纳入了 1,743 名参与者。参与者接受了CAC评分，并评估了脂肪肝指数（FLI）、纤维化非酒精性脂肪性肝炎指数（FNI）和纤维化-4指数（FIB-4评分），这些都是脂肪变性和纤维化的指标。计算多变量逻辑回归模型。结果 结果显示肝脏脂肪变性/纤维化与 CAC 之间存在关联。与 FLI <30 相比，FLI > 60 与更高的 NAFLD 几率相关（OR 3.38，95% CI：2.61-4.39，p < 0.01），并且 CAC 评分 > 300 的患病率增加（9% vs. 3%，p < 0.01），即使在调整了传统的心脏代谢危险因素后也是如此。虽然 FIB-4 评分 ≥ 1.3 和 FNI 评分的粗比值比与 CAC 几率增加显着相关，但在调整年龄、性别和 MetS 后，它们变得不显着。结论 这项研究揭示了 NAFLD 和 CAC 之间的显着关联。研究结果表明，评估肝脏脂肪和纤维化可以增强对心血管风险的评估，但还需要进一步研究来确定肝脂肪是否在动脉粥样硬化的发展中发挥独立作用，以及针对肝脏脂肪变性是否可以减轻血管风险。