Fatty liver may increase heart disease, mortality

London: A patient suffering from fatty liver disease is prone to an increased risk of heart disease as well as the mortality rates associated with it, a new study has found.

Non-alcoholic fatty liver disease (NAFLD) is an increasingly common condition in patients with obesity, type 2 diabetes and arterial hypertension -- where high blood pressure in the arteries is persistently elevated.

The findings showed that NAFLD is an independent risk factor for atherosclerosis -- the build-up of fats, cholesterol and other substances in and on the artery walls -- which may lead to the advent of cardiovascular disease (CVD) -- heart diseases -- related deaths.

"Evidence indicates that the fatty and inflamed liver expresses several pro-inflammatory and procoagulant factors, as well as genes involved in accelerated atherogenesis," said led researcher Raluca Pais from Pierre and Marie Curie University in Paris, France.

"This raises the possibility that the link between NAFLD and cardiovascular mortality might not simply be mediated by shared, underlying, common risk factors, but rather that NAFLD independently contributes to increasing this risk," added one of the researchers Vlad Ratziu, professor.

In patients with metabolic syndrome health problems like diabetes and stroke at risk for heart disease events, NAFLD contributes to early atherosclerosis and its progression, independent of traditional cardiovascular risk factors.

"This indicates that NAFLD is a precursor of metabolic syndrome. It follows that the diagnosis of fatty liver is extremely important and therefore a thorough cardiovascular and metabolic work-up and strict monitoring of CVD or metabolic complications are needed in the clinical management of NAFLD," Pais noted in the paper published in Journal of Hepatology.

The team undertook a large retrospective study of close to 6,000 patients between 1995 and 2012 to assess whether NAFLD is incidental to or is the cause of atherosclerosis of the carotid arteries.

Using the Fatty Liver Index (FLI) a well-validated biomarker, researchers observed that fatty liver is associated with thickness in the major blood vessels in the neck -- a pre-atherosclerotic problem that predicts heart disease events. 

Thickness in the blood vessels increases proportionally with FLI, and this association is independent of traditional cardiometabolic risk factors -- like diabetes, heart disease or stroke.

Futher, patients with fatty liver were more likely to develop in the plaques resulting in thickness in the blood vessels over time. 

Fatty liver disease at baseline predicted the occurrence of carotid plaques independent of age, sex, type 2 diabetes, tobacco use, and other heart disease risk factors.

Strict monitoring of cardiovascular disease recommended when managing nonalcoholic fatty liver disease, the researchers suggested.