BACKGROUND & AIMS: The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing, with concomitant high incidence of lipoprotein abnormalities. Cardiovascular disease (CVD) is the main cause of death in subjects with NAFLD and management of dyslipidemia is pivotal for prevention. We aimed to determine cardiovascular risk and indication for statin therapy in subjects with NAFLD.
METHODS: Cross sectional analysis of the population-based Lifelines Cohort Study of 34,240 adult individuals. Subjects with reported use of lipid-lowering drugs were excluded. Suspected NAFLD was defined as Fatty Liver Index (FLI) ≥60 and advanced hepatic fibrosis as NAFLD fibrosis score (NFS) >0.676. Cardiovascular risk and indication for statin therapy were defined according to the European Society of Cardiology and European Atherosclerosis Society Guideline for the Management of Dyslipidemias.
RESULTS: FLI≥60 was present in 7,067 (20.6%) participants and coincided with increased prevalence of type 2 diabetes mellitus, metabolic syndrome, CVD and impaired renal function (all P<0.001). 10-Year predicted cardiovascular risk was significantly increased in subjects with elevated FLI and NFS (both P<0.001). Indication for statin use was significantly increased in subjects with FLI≥60 (31.0% vs. 15.6%, P<0.001) and NFS>0.676 (73.2% vs. 30.6%, P<0.001). In multivariable analyses FLI≥60 (OR 1.26, 95%CI: 1.13-1.41%, P<0.001) and NFS>0.676 (OR 5.03, 95%CI: 2.76-9.17%, P<0.001) were independent predictors for indication regarding statin therapy.
CONCLUSIONS: Because of increased cardiovascular risk, substantial proportions of subjects with suspected NAFLD and/or fibrosis have an indication for lipid-lowering treatment and could benefit from statin therapy. This article is protected by copyright. All rights reserved.
- cardiovascular risk
- fatty liver Index
- NAFLD fibrosis score
- non-alcoholic fatty liver disease
- statin therapy
- METABOLIC SYNDROME
- HEPATIC STEATOSIS
- FIBROSIS STAGE
Bakker, S. (Creator), Dotinga, A. (Creator), Vonk, J. (Creator), Smidt, N. (Creator), Scholtens, S. (Creator), Swertz, M. (Creator), Wijmenga, C. (Creator), Wolffenbuttel, B. (Creator), Stolk, R. (Creator), van Zon, S. (Creator), Rosmalen, J. (Creator), Postma, D. (Creator), de Boer, R. (Creator), Navis, G. (Creator), Slaets, J. (Creator), Ormel, H. (Creator), van Dijk, F. (Creator) & Bolmer, B. (Data Manager), Lifelines, 2006