Skip to main content

Advertisement

SpringerLink
Log in

Nonalcoholic Fatty Liver Disease and the Coronary Artery Disease

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent and is recognized as part of the metabolic syndrome (MetS). Patients with NAFLD have a lower life expectancy compared to the general population, with coronary artery disease (CAD) as the leading cause of death.

Aims

We aim to address the epidemiological data of CAD, the possible pathogenesis or linkage mechanisms of NAFLD and atherosclerosis and the strategies to reduce the CAD risk in NAFLD patients.

Methods

We reviewed data from a Medline and PubMed search which was performed to identify relevant literature using search terms “NAFLD,” “metabolic syndrome” and “coronary artery disease.”

Results

Patients with steatohepatitis, a part of the spectrum of NAFLD, have more cardiovascular events than patients without steatohepatitis. However, the association between liver histological progression and the risk of CAD events is not linear. A multidisciplinary approach to NAFLD patients based on controlling related risk factors and monitoring for CAD risks and liver complications is necessary. The combination of lifestyle modification with pharmacological treatment tailored to each individual’s risk factors needs to be considered. There is a need for more research on primary prevention for CAD in NAFLD patients and interventional studies for determining the nature of the relationship between NAFLD and CAD.

Conclusions

NAFLD is recognized as part of the MetS and increases cardiovascular risks. Therefore, a multidisciplinary approach to these patients of controlling the related risk factors and monitoring for cardiovascular and liver complications must be done.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ALP:

Alkaline phosphatase

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

BMI:

Body mass index

CAD:

Coronary artery disease

DM:

Diabetes mellitus

FRS:

Framingham risk score

HDL-C:

High density lipoprotein cholesterol

MetS:

Metabolic syndrome

IR:

Insulin resistance

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

References

  1. Brunt EM. Pathology of nonalcoholic steatohepatitis. Hepatol Res. 2005;33:68–71.

    Article  CAS  PubMed  Google Scholar 

  2. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology. 2006;43:S99–S112.

    Article  CAS  PubMed  Google Scholar 

  3. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–1321.

    Article  PubMed  Google Scholar 

  4. Adams LA, Lindor KD. Nonalcoholic fatty liver disease. Ann Epidemiol. 2007;17:863–869.

    Article  PubMed  Google Scholar 

  5. Fan JG, Farrell GC. Epidemiology of non-alcoholic fatty liver disease in china. J Hepatol. 2009;50:204–210.

    Article  PubMed  Google Scholar 

  6. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA. Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology. 1994;107:1103–1109.

    CAS  PubMed  Google Scholar 

  7. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116:1413–1419.

    Article  CAS  PubMed  Google Scholar 

  8. Adams LA, Lymp JF, St Sauver J, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129:113–121.

    Article  PubMed  Google Scholar 

  9. Rafiq N, Bai C, Fang Y, et al. Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol. 2009;7:234–238.

    Article  PubMed  Google Scholar 

  10. Dam-Larsen S, Becker U, Franzmann MB, Larsen K, Christoffersen P, Bendtsen F. Final results of a long-term, clinical follow-up in fatty liver patients. Scand J Gastroenterol. 2009;44:1236–1243.

    Article  CAS  PubMed  Google Scholar 

  11. Dam-Larsen S, Franzmann M, Andersen IB, et al. Long term prognosis of fatty liver: risk of chronic liver disease and death. Gut. 2004;53:750–755.

    Article  CAS  PubMed  Google Scholar 

  12. Targher G, Bertolini L, Padovani R, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30:1212–1218.

    Article  PubMed  Google Scholar 

  13. Chen CH, Nien CK, Yang CC, Yeh YH. Association between nonalcoholic fatty liver disease and coronary artery calcification. Dig Dis Sci. doi:10.1007/s10620-009-0935-9.

  14. Arslan U, Turkoglu S, Balcioglu S, Tavil Y, Karakan T, Cengel A. Association between nonalcoholic fatty liver disease and coronary artery disease. Coron Artery Dis. 2007;18:433–436.

    Article  PubMed  Google Scholar 

  15. Ong JP, Pitts A, Younossi ZM. Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease. J Hepatol. 2008;49:608–612.

    Article  PubMed  Google Scholar 

  16. Khashab MA, Liangpunsakul S, Chalasani N. Nonalcoholic fatty liver disease as a component of the metabolic syndrome. Curr Gastroenterol Rep. 2008;10:73–80.

    Article  PubMed  Google Scholar 

  17. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–2497.

    Google Scholar 

  18. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366:1059–1062.

    Article  PubMed  Google Scholar 

  19. International Diabetes Federation: The IDF, consensus worldwide definition of the metabolic syndrome. http://wwwidforg/webdata/docs/IDF_Meta_def_finalpdf 2005. Accessed June 10, 2005.

  20. Sung KC, Ryan MC, Wilson AM. The severity of nonalcoholic fatty liver disease is associated with increased cardiovascular risk in a large cohort of non-obese Asian subjects. Atherosclerosis. 2009;203:581–586.

    Article  CAS  PubMed  Google Scholar 

  21. Zhao XQ, Krasuski RA, Baer J, et al. Effects of combination lipid therapy on coronary stenosis progression and clinical cardiovascular events in coronary disease patients with metabolic syndrome: a combined analysis of the familial atherosclerosis treatment study (FATS), the HDL-atherosclerosis treatment study (HATS), and the armed forces regression study (AFREGS). Am J Cardiol. 2009;104:1457–1464.

    Article  CAS  PubMed  Google Scholar 

  22. Kramer CK, von Muhlen D, Gross JL, Laughlin GA, Barrett-Connor E. Blood pressure and fasting plasma glucose rather than metabolic syndrome predict coronary artery calcium progression: The Rancho Bernardo study. Diabetes Care. 2009;32:141–146.

    Article  CAS  PubMed  Google Scholar 

  23. Ebrahimi M, Kazemi-Bajestani SM, Ghayour-Mobarhan M, et al. Metabolic syndrome may not be a good predictor of coronary artery disease in the Iranian population: population-specific definitions are required. Sci World J. 2009;9:86–96.

    Google Scholar 

  24. Kadayifci A, Tan V, Ursell PC, Merriman RB, Bass NM. Clinical and pathologic risk factors for atherosclerosis in cirrhosis: a comparison between NASH-related cirrhosis and cirrhosis due to other aetiologies. J Hepatol. 2008;49:595–599.

    Article  PubMed  Google Scholar 

  25. Hamaguchi M, Kojima T, Takeda N, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease. World J Gastroenterol. 2007;13:1579–1584.

    CAS  PubMed  Google Scholar 

  26. Schindhelm RK, Dekker JM, Nijpels G, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn study. Atherosclerosis. 2007;191:391–396.

    Article  CAS  PubMed  Google Scholar 

  27. Treeprasertsuk S, Angulo P, Adams LA, Lindor KD. The Framingham risk score accurately predicts the higher risk of coronary heart disease in patients with nonalcoholic fatty liver disease. Gastroenterology. 2009;136:97(Suppl 91, abstract no. 645).

    Google Scholar 

  28. Ekstedt M, Franzen LE, Mathiesen UL, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006;44:865–873.

    Article  CAS  PubMed  Google Scholar 

  29. Rubinstein E, Lavine JE, Schwimmer JB. Hepatic, cardiovascular, and endocrine outcomes of the histological subphenotypes of nonalcoholic fatty liver disease. Semin Liver Dis. 2008;28:380–385.

    Article  PubMed  Google Scholar 

  30. Kim CH, Younossi ZM. Nonalcoholic fatty liver disease: a manifestation of the metabolic syndrome. Cleve Clin J Med. 2008;75:721–728.

    Article  PubMed  Google Scholar 

  31. Edmison J, McCullough AJ. Pathogenesis of non-alcoholic steatohepatitis: human data. Clin Liver Dis. 2007;11:75–104, ix.

    Google Scholar 

  32. Kotronen A, Juurinen L, Tiikkainen M, Vehkavaara S, Yki-Jarvinen H. Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. Gastroenterology. 2008;135:122–130.

    Article  CAS  PubMed  Google Scholar 

  33. Cersosimo E, DeFronzo RA. Insulin resistance and endothelial dysfunction: the road map to cardiovascular diseases. Diabetes Metab Res Rev. 2006;22:423–436.

    Article  CAS  PubMed  Google Scholar 

  34. Targher G, Bertolini L, Padovani R, et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care. 2006;29:1325–1330.

    Article  PubMed  Google Scholar 

  35. Gastaldelli A, Kozakova M, Hojlund K, Flyvbjerg A, Favuzzi A, Mitrakou A, Balkau B. Fatty liver is associated with insulin resistance, risk of coronary heart disease, and early atherosclerosis in a large European population. Hepatology. 2009;49:1537–1544.

    Google Scholar 

  36. Ammar KA, Redfield MM, Mahoney DW, Johnson M, Jacobsen SJ, Rodeheffer RJ. Central obesity: association with left ventricular dysfunction and mortality in the community. Am Heart J. 2008;156:975–981.

    Article  PubMed  Google Scholar 

  37. van der Poorten D, Milner KL, Hui J, et al. Visceral fat: a key mediator of steatohepatitis in metabolic liver disease. Hepatology. 2008;48:449–457.

    Article  PubMed  Google Scholar 

  38. Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference as a screening tool for cardiovascular risk factors: evaluation of receiver operating characteristics (ROC). Obes Res. 1996;4:533–547.

    CAS  PubMed  Google Scholar 

  39. Marques MD, Santos RD, Parga JR, Rocha-Filho JA, Quaglia LA, Miname MH, Avila LF. Relation between visceral fat and coronary artery disease evaluated by multidetector computed tomography. Atherosclerosis. 2009;120:2029–2032.

    Google Scholar 

  40. McKimmie RL, Daniel KR, Carr JJ, et al. Hepatic steatosis and subclinical cardiovascular disease in a cohort enriched for type 2 diabetes: the diabetes heart study. Am J Gastroenterol. 2008;103:3029–3035.

    Article  CAS  PubMed  Google Scholar 

  41. Otsuka F, Sugiyama S, Kojima S, et al. Hypoadiponectinemia is associated with impaired glucose tolerance and coronary artery disease in non-diabetic men. Circ J. 2007;71:1703–1709.

    Article  CAS  PubMed  Google Scholar 

  42. Hashimoto N, Kanda J, Nakamura T, et al. Association of hypoadiponectinemia in men with early onset of coronary heart disease and multiple coronary artery stenoses. Metabolism. 2006;55:1653–1657.

    Article  CAS  PubMed  Google Scholar 

  43. Wannamethee SG. Adiponectin and cardiovascular risk prediction: can the ambiguities be resolved? Nutr Metab Cardiovasc Dis. 2008;18:581–584.

    Article  PubMed  Google Scholar 

  44. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847.

    CAS  PubMed  Google Scholar 

  45. Cosin Aguilar J, Hernandiz Martinez A, Rodriguez Padial L, et al. Assessment of cardiovascular risk in population groups. Comparison of score system and Framingham in hypertensive patients. Rev Clin Esp. 2006;206:182–187.

    Article  CAS  PubMed  Google Scholar 

  46. Ford ES, Giles WH, Mokdad AH. The distribution of 10-year risk for coronary heart disease among us adults: findings from the National Health and Nutrition examination survey iii. J Am Coll Cardiol. 2004;43:1791–1796.

    Article  PubMed  Google Scholar 

  47. Ioannou GN, Weiss NS, Boyko EJ, Mozaffarian D, Lee SP. Elevated serum alanine aminotransferase activity and calculated risk of coronary heart disease in the United States. Hepatology. 2006;43:1145–1151.

    Article  CAS  PubMed  Google Scholar 

  48. Villanova N, Moscatiello S, Ramilli S, et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology. 2005;42:473–480.

    Article  PubMed  Google Scholar 

  49. Angulo P. NAFLD, obesity, and bariatric surgery. Gastroenterology. 2006;130:1848–1852.

    Article  PubMed  Google Scholar 

  50. Jaquet A, Deloumeaux J, Dumoulin M, Bangou J, Donnet JP, Foucan L. Metabolic syndrome and Framingham risk score for prediction of cardiovascular events in Caribbean Indian patients with blood glucose abnormalities. Diabetes Metab. 2008;34:177–181.

    Google Scholar 

  51. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J. 2007;28:2375.

    Article  PubMed  Google Scholar 

  52. Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ. 2000;321:199–204.

    Article  CAS  PubMed  Google Scholar 

  53. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499–511.

    Article  PubMed  Google Scholar 

  54. Hui JM, Farrell GC, Kench JG, George J. High sensitivity C-reactive protein values do not reliably predict the severity of histological changes in NAFLD. Hepatology. 2004;39:1458–1459.

    Article  PubMed  Google Scholar 

  55. Chambers JC, Eda S, Bassett P, et al. C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation. 2001;104:145–150.

    CAS  PubMed  Google Scholar 

  56. Yoneda M, Mawatari H, Fujita K, et al. High-sensitivity C-reactive protein is an independent clinical feature of nonalcoholic steatohepatitis (NASH) and also of the severity of fibrosis in NASH. J Gastroenterol. 2007;42:573–582.

    Article  CAS  PubMed  Google Scholar 

  57. Targher G, Bertolini L, Rodella S, et al. NASH predicts plasma inflammatory biomarkers independently of visceral fat in men. Obesity (Silver Spring). 2008;16:1394–1399.

    Article  CAS  Google Scholar 

  58. Lizardi-Cervera J, Chavez-Tapia NC, Perez-Bautista O, Ramos MH, Uribe M. Association among C-reactive protein, fatty liver disease, and cardiovascular risk. Dig Dis Sci. 2007;52:2375–2379.

    Article  CAS  PubMed  Google Scholar 

  59. Luster AD. Chemokines–chemotactic cytokines that mediate inflammation. N Engl J Med. 1998;338:436–445.

    Article  CAS  PubMed  Google Scholar 

  60. Charo IF, Ransohoff RM. The many roles of chemokines and chemokine receptors in inflammation. N Engl J Med. 2006;354:610–621.

    Article  CAS  PubMed  Google Scholar 

  61. Charo IF, Taubman MB. Chemokines in the pathogenesis of vascular disease. Circ Res. 2004;95:858–866.

    Article  CAS  PubMed  Google Scholar 

  62. Tretjakovs P, Jurka A, Bormane I, et al. Relation of inflammatory chemokines to insulin resistance and hypoadiponectinemia in coronary artery disease patients. Eur J Intern Med. 2009;20:712–717.

    Article  CAS  PubMed  Google Scholar 

  63. Lindmark E, Diderholm E, Wallentin L, Siegbahn A. Relationship between interleukin 6 and mortality in patients with unstable coronary artery disease: effects of an early invasive or noninvasive strategy. JAMA. 2001;286:2107–2113.

    Article  CAS  PubMed  Google Scholar 

  64. Tan J, Hua Q, Gao J, Fan ZX. Clinical implications of elevated serum interleukin-6, soluble CD40 ligand, metalloproteinase-9, and tissue inhibitor of metalloproteinase-1 in patients with acute ST-segment elevation myocardial infarction. Clin Cardiol. 2008;31:413–418.

    Article  PubMed  Google Scholar 

  65. Zhang R, Brennan ML, Fu X, et al. Association between myeloperoxidase levels and risk of coronary artery disease. JAMA. 2001;286:2136–2142.

    Article  CAS  PubMed  Google Scholar 

  66. Brennan ML, Penn MS, Van Lente F, et al. Prognostic value of myeloperoxidase in patients with chest pain. N Engl J Med. 2003;349:1595–1604.

    Article  CAS  PubMed  Google Scholar 

  67. Rensen SS, Slaats Y, Nijhuis J, et al. Increased hepatic myeloperoxidase activity in obese subjects with nonalcoholic steatohepatitis. Am J Pathol. 2009;175:1473–1482.

    Article  CAS  PubMed  Google Scholar 

  68. Despres JP. Cardiovascular disease under the influence of excess visceral fat. Crit Pathw Cardiol. 2007;6:51–59.

    PubMed  Google Scholar 

  69. Arsenault BJ, Rana JS, Lemieux I, Despres JP, Kastelein JJ, Boekholdt SM, Wareham NJ, Khaw KT. Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women. Int J Obes (Lond) 2010;34:340–347.

    Google Scholar 

  70. Pignone MP, Phillips CJ, Atkins D, Teutsch SM, Mulrow CD, Lohr KN. Screening and treating adults for lipid disorders. Am J Prev Med. 2001;20:77–89.

    Article  CAS  PubMed  Google Scholar 

  71. Sofi F, Capalbo A, Cesari F, Abbate R, Gensini GF. Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil. 2008;15:247–257.

    Article  PubMed  Google Scholar 

  72. Huang MA, Greenson JK, Chao C, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. Am J Gastroenterol. 2005;100:1072–1081.

    Article  PubMed  Google Scholar 

  73. Kantartzis K, Thamer C, Peter A, Machann J, Schick F, Schraml C, Konigsrainer A, Konigsrainer I, Krober S, Niess A, Fritsche A, Haring HU, Stefan N. High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease. Gut 2009;58:1281–1288.

    Google Scholar 

  74. Chen SM, Liu CY, Li SR, Huang HT, Tsai CY, Jou HJ. Effects of therapeutic lifestyle program on ultrasound-diagnosed nonalcoholic fatty liver disease. J Chin Med Assoc. 2008;71:551–558.

    Article  CAS  PubMed  Google Scholar 

  75. Harrison SA, Fecht W, Brunt EM, Neuschwander-Tetri BA. Orlistat for overweight subjects with nonalcoholic steatohepatitis: a randomized, prospective trial. Hepatology. 2009;49:80–86.

    Article  CAS  PubMed  Google Scholar 

  76. Bellentani S, Dalle Grave R, Suppini A, Marchesini G. Behavior therapy for nonalcoholic fatty liver disease: the need for a multidisciplinary approach. Hepatology. 2008;47:746–754.

    Article  PubMed  Google Scholar 

  77. Elmer PJ, Obarzanek E, Vollmer WM, et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med. 2006;144:485–495.

    PubMed  Google Scholar 

  78. St George A, Bauman A, Johnston A, Farrell G, Chey T, George J. Effect of a lifestyle intervention in patients with abnormal liver enzymes and metabolic risk factors. J Gastroenterol Hepatol. 2009;24:399–407.

    Article  CAS  PubMed  Google Scholar 

  79. Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51:121–129.

    CAS  PubMed  Google Scholar 

  80. Kantartzis K, Thamer C, Peter A, et al. High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease. Gut. 2009;58:1281–1288.

    Article  CAS  PubMed  Google Scholar 

  81. Pontiroli AE, Pizzocri P, Librenti MC, et al. Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications: a three-year study. J Clin Endocrinol Metab. 2002;87:3555–3561.

    Article  PubMed  Google Scholar 

  82. Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299:316–323.

    Article  CAS  PubMed  Google Scholar 

  83. Mummadi RR, Kasturi KS, Chennareddygari S, Sood GK. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2008;6:1396–1402.

    Article  PubMed  Google Scholar 

  84. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357:753–761.

    Article  CAS  PubMed  Google Scholar 

  85. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–752.

    Article  PubMed  Google Scholar 

  86. Sjostrom L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes (Lond). 2008;32(Suppl 7):S93–S97.

    Article  Google Scholar 

  87. Machado M, Cortez-Pinto H. Non-alcoholic fatty liver disease and insulin resistance. Eur J Gastroenterol Hepatol. 2005;17:823–826.

    Article  CAS  PubMed  Google Scholar 

  88. Ibdah JA, Perlegas P, Zhao Y, et al. Mice heterozygous for a defect in mitochondrial trifunctional protein develop hepatic steatosis and insulin resistance. Gastroenterology. 2005;128:1381–1390.

    Article  CAS  PubMed  Google Scholar 

  89. Angelico F, Burattin M, Alessandri C, Del Ben M, Lirussi F. Drugs improving insulin resistance for non-alcoholic fatty liver disease and/or non-alcoholic steatohepatitis. Cochrane Database Syst Rev 2007;1:CD005166.

    Google Scholar 

  90. Loomba R, Lutchman G, Kleiner DE, et al. Clinical trial: pilot study of metformin for the treatment of nonalcoholic steatohepatitis. Aliment Pharmacol Ther. 2008;29:172–182.

    Article  PubMed  Google Scholar 

  91. Aithal GP, Thomas JA, Kaye PV, et al. Randomized, placebo-controlled trial of pioglitazone in nondiabetic subjects with nonalcoholic steatohepatitis. Gastroenterology. 2008;135:1176–1184.

    Article  CAS  PubMed  Google Scholar 

  92. Lutchman G, Modi A, Kleiner DE, et al. The effects of discontinuing pioglitazone in patients with nonalcoholic steatohepatitis. Hepatology. 2007;46:424–429.

    Article  CAS  PubMed  Google Scholar 

  93. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356:2457–2471.

    Article  CAS  PubMed  Google Scholar 

  94. Lincoff AM, Wolski K, Nicholls SJ, Nissen SE. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA. 2007;298:1180–1188.

    Article  CAS  PubMed  Google Scholar 

  95. Chalasani NP, Sanyal AJ, Kowdley KV, et al. Pioglitazone versus vitamin E versus placebo for the treatment of non-diabetic patients with non-alcoholic steatohepatitis: Pivens trial design. Contemp Clin Trials. 2009;30:88–96.

    Article  CAS  PubMed  Google Scholar 

  96. Stein LL, Dong MH, Loomba R. Insulin sensitizers in nonalcoholic fatty liver disease and steatohepatitis: current status. Adv Ther. 2009;26:893–907.

    Article  CAS  PubMed  Google Scholar 

  97. Chalasani N. Statins and hepatotoxicity: focus on patients with fatty liver. Hepatology. 2005;41:690–695.

    Article  CAS  PubMed  Google Scholar 

  98. Chalasani N, Aljadhey H, Kesterson J, Murray MD, Hall SD. Patients with elevated liver enzymes are not at higher risk for statin hepatotoxicity. Gastroenterology. 2004;126:1287–1292.

    Article  CAS  PubMed  Google Scholar 

  99. Lewis JH, Mortensen ME, Zweig S, Fusco MJ, Medoff JR, Belder R. Efficacy and safety of high-dose pravastatin in hypercholesterolemic patients with well-compensated chronic liver disease: results of a prospective, randomized, double-blind, placebo-controlled, multicenter trial. Hepatology. 2007;46:1453–1463.

    Article  CAS  PubMed  Google Scholar 

  100. Rallidis LS, Drakoulis CK, Parasi AS. Pravastatin in patients with nonalcoholic steatohepatitis: results of a pilot study. Atherosclerosis. 2004;174:193–196.

    Article  CAS  PubMed  Google Scholar 

  101. Gould AL, Rossouw JE, Santanello NC, Heyse JF, Furberg CD. Cholesterol reduction yields clinical benefit: impact of statin trials. Circulation. 1998;97:946–952.

    CAS  PubMed  Google Scholar 

  102. Hebert PR, Gaziano JM, Chan KS, Hennekens CH. Cholesterol lowering with statin drugs, risk of stroke, and total mortality. An overview of randomized trials. JAMA. 1997;278:313–321.

    Article  CAS  PubMed  Google Scholar 

  103. Fujita K, Nozaki Y, Wada K, et al. Effectiveness of antiplatelet drugs against experimental non-alcoholic fatty liver disease. Gut. 2008;57:1583–1591.

    Article  CAS  PubMed  Google Scholar 

  104. Georgescu EF. Angiotensin receptor blockers in the treatment of NASH/NAFLD: could they be a first-class option? Adv Ther. 2008;25:1141–1174.

    Article  CAS  PubMed  Google Scholar 

  105. Rosselli MS, Burgueno AL, Carabelli J, Schuman M, Pirola CJ, Sookoian S. Losartan reduces liver expression of plasminogen activator inhibitor-1 (PAI-1) in a high fat-induced rat nonalcoholic fatty liver disease model. Atherosclerosis. 2009;206:119–126.

    Article  CAS  PubMed  Google Scholar 

  106. Enjoji M, Kotoh K, Kato M, et al. Therapeutic effect of ARBs on insulin resistance and liver injury in patients with NAFLD and chronic hepatitis C: a pilot study. Int J Mol Med. 2008;22:521–527.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Sombat Treeprasertsuk was granted a medical research scholarship from the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Conflict of interest

No conflicts of interest exist.

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, Fiterman Center for Digestive Diseases, 200 First Street, SW, Rochester, MN, 55905, USA

    Sombat Treeprasertsuk & Keith D. Lindor

  2. Faculty of Medicine, Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand

    Sombat Treeprasertsuk

  3. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA

    Francisco Lopez-Jimenez

Authors
  1. Sombat Treeprasertsuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francisco Lopez-Jimenez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith D. Lindor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sombat Treeprasertsuk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Treeprasertsuk, S., Lopez-Jimenez, F. & Lindor, K.D. Nonalcoholic Fatty Liver Disease and the Coronary Artery Disease. Dig Dis Sci 56, 35–45 (2011). https://doi.org/10.1007/s10620-010-1241-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-010-1241-2

Keywords

Search

Navigation