Ralph L Widya MD, Abstract Co-Author: Nothing to Disclose

Renée De Mutsert, Abstract Co-Author: Nothing to Disclose

Hildo J. Lamb PhD, Presenter: Nothing to Disclose

Jan W. A. Smit MD, PhD, Abstract Co-Author: Nothing to Disclose

Jos Westenberg PhD, Abstract Co-Author: Nothing to Disclose

Wouter J. Jukema MD, Abstract Co-Author: Nothing to Disclose

Klaus F Rabe, Abstract Co-Author: Nothing to Disclose

Ton J Rabelink, Abstract Co-Author: Nothing to Disclose

Saskia Middeldorp, Abstract Co-Author: Nothing to Disclose

Frits R Rosendaal MD, Abstract Co-Author: Nothing to Disclose

Albert De Roos MD, Abstract Co-Author: Nothing to Disclose

Nonalcoholic liver disease (NAFLD) is highly prevalent among obese persons and diabetic patients (70-90%) and may contribute to an increased cardiovascular risk. NAFLD covers a spectrum of simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. The histologic severity of NASH is associated with greater carotid-artery intimal medial thickness. The relationship of NAFLD with cardiovascular disease (CVD) in the intermediate state of simple steatosis and visceral adiposity has not been fully determined yet. Therefore, the purpose was to investigate the association between NAFLD and aortic pulse wave velocity (PWV), as a marker for CVD, in an obese population.

This cross-sectional analysis of baseline measurements of the Netherlands Epidemiology of Obesity (NEO) study, a cohort of individuals 45-65 yrs with a BMI≥27 kg/m2, included 83 participants. Proton (1H)-MRS was performed to assess hepatic triglyceride (TG) content. Participants were divided in a low and high liver fat-group according to the median value of hepatic TG content. Velocity-encoded MRI was performed to assess aortic PWV, visceral adipose tissue (VAT) was assessed by a TSE MR protocol. The associations of hepatic TG content with VAT and PWV were studied using linear regression analysis, adjusted for age, sex, BMI and smoking.

Mean age (±SD) was 55.2±6.0 yrs (low liver fat-group 55.5±6.5 vs. high liver fat-group 55.2±5.6 yrs; p=0.824) and the mean BMI was 30.3±3.4 kg/m2 (30.1±3.3 vs. 30.5±3.6 kg/m2; p=0.570). The median value of hepatic TG content was 7.5% (2.7±1.3 vs. 17.3±8.5%; p<0.001). Subjects in the low liver fat-group had less VAT compared to the high liver fat-group (368±136 vs. 454±196 cm3; p< 0.05). Aortic PWV was not significantly different (6.6±1.9 vs. 6.5±1.5 m/s; p=0.813). Hepatic TG content was strongly associated with VAT (ß 0.19; 95%CI 0.006,0.031; R2 0.113), but not with aortic PWV (ß -0.012; 95%CI -0.038,0.014; R2 0.011).

Despite the well known increased risk of CVD in obesity, our results show that this risk is not yet evident in the intermediate state of simple steatosis and visceral adiposity. This may indicate that cardiovascular risk increases with the severity of NAFLD, and may be detectable in the necroinflammatory milieu of NASH.

In consideration of the epidemic of obesity, staging of NAFLD is of importance to estimate the risk for CVD in the overweight and obese population.

Widya, R, De Mutsert, R, Lamb, H, Smit, J, Westenberg, J, Jukema, W, Rabe, K, Rabelink, T, Middeldorp, S, Rosendaal, F, De Roos, A, Cardiovascular Risk Is Not Yet Evident in the Intermediate State of Simple Steatosis and Visceral Adiposity.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034402.html