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Clinical Study
The Relationship between 10-Year Cardiovascular Risk Calculated Using the Pooled Cohort Equation and the Severity of Non-Alcoholic Fatty Liver Disease
Jeong In Lee, Min Chul Kim, Byung Sub Moon, Young Seok Song, Eun Na Han, Hyo Sun Lee, Yoonjeong Son, Jihyun Kim, Eun Jin Han, Hye-Jeong Park, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2016;31(1):86-92.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.86
  • 4,792 View
  • 40 Download
  • 21 Web of Science
  • 23 Crossref
AbstractAbstract PDFPubReader   
Background

We investigated the association between the severity of non-alcoholic fatty liver disease (NAFLD) and the estimated 10-year risk of cardiovascular disease (CVD) calculated by Pooled Cohort Equation (PCE) and Framingham risk score (FRS).

Methods

A total of 15,913 participants (mean age, 46.3 years) in a health screening program were selected for analysis. The presence and severity of fatty liver was assessed by abdominal ultrasonogram. Subjects who drank alcohol more than three times a week were excluded from the study.

Results

Among the participants, 57.6% had no NAFLD, 35.4% had grade I, 6.5% had grade II, and 0.5% had grade III NAFLD. Mean estimated 10-year CVD risk was 2.59%, 3.93%, 4.68%, and 5.23% calculated using the PCE (P for trend <0.01) and 4.55%, 6.39%, 7.33%, and 7.13% calculated using FRS, according to NAFLD severity from none to severe (P for trend <0.01). The odds ratio for ≥7.5% estimated CVD risk calculated using the PCE showed a higher correlation with increasing severity of NAFLD even after adjustment for conventional CVD risk factors (1.52, 2.56, 3.35 vs. the no NAFLD group as a reference, P<0.01) compared with calculated risk using FRS (1.65, 1.62, 1.72 vs. no NAFLD group as a reference, P<0.01).

Conclusion

In our study of apparently healthy Korean adults, increasing severity of NAFLD showed a higher correlation with estimated 10-year CVD risk when calculated using the PCE than when calculated using FRS.

Citations

Citations to this article as recorded by  
  • Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
    Dana Kablawi, Faisal Aljohani, Chiara Saroli Palumbo, Sophie Restellini, Alain Bitton, Gary Wild, Waqqas Afif, Peter L Lakatos, Talat Bessissow, Giada Sebastiani
    Crohn's & Colitis 360.2023;[Epub]     CrossRef
  • Low Relative Handgrip Strength Is Associated with a High Risk of Non-Alcoholic Fatty Liver Disease in Italian Adults: A Retrospective Cohort Study
    Samantha Maurotti, Roberta Pujia, Elisa Mazza, Maria Francesca Pileggi, Franco Arturi, Maria Grazia Tarsitano, Tiziana Montalcini, Arturo Pujia, Yvelise Ferro
    Applied Sciences.2023; 13(22): 12489.     CrossRef
  • Fatty Liver Disease: Diagnosis and Stratification
    Yedidya Saiman, Andres Duarte-Rojo, Mary E. Rinella
    Annual Review of Medicine.2022; 73(1): 529.     CrossRef
  • “Dangerous liaisons: NAFLD and liver fibrosis increase cardiovascular risk in HIV”
    Adriana Cervo, Giada Sebastiani, Jovana Milic, Thomas Krahn, Sergio Mazzola, Salvatore Petta, Antonio Cascio, Giovanni Guaraldi, Giovanni Mazzola
    HIV Medicine.2022; 23(8): 911.     CrossRef
  • Value of the triglyceride glucose index combined with body mass index in identifying non-alcoholic fatty liver disease in patients with type 2 diabetes
    Nong Li, Huiwen Tan, Aixia Xie, Cheng Li, Xuan Fu, Weiting Xang, Amina Kirim, Xuefang Huang
    BMC Endocrine Disorders.2022;[Epub]     CrossRef
  • The Relation Between Non-alcoholic Fatty Liver Disease and the Risk of Coronary Heart Disease
    Seyed Moayed Alavian, Hosein Zadi
    Multidisciplinary Cardiovascular Annals.2022;[Epub]     CrossRef
  • Risk factors for cardiovascular disease among individuals with hepatic steatosis
    Julia Karády, Maros Ferencik, Thomas Mayrhofer, Nandini M. Meyersohn, Daniel O. Bittner, Pedro V. Staziaki, Balint Szilveszter, Travis R. Hallett, Michael T. Lu, Stefan B. Puchner, Tracey G. Simon, Borek Foldyna, Geoffrey S. Ginsburg, Robert W. McGarrah,
    Hepatology Communications.2022; 6(12): 3406.     CrossRef
  • Triglyceride Glucose Index and Related Parameters (Triglyceride Glucose-Body Mass Index and Triglyceride Glucose-Waist Circumference) Identify Nonalcoholic Fatty Liver and Liver Fibrosis in Individuals with Overweight/Obesity
    Mohammad E. Khamseh, Mojtaba Malek, Rowshanak Abbasi, Hoda Taheri, Maryam Lahouti, Fariba Alaei-Shahmiri
    Metabolic Syndrome and Related Disorders.2021; 19(3): 167.     CrossRef
  • Interplay between non‐alcoholic fatty liver disease and cardiovascular risk in an asymptomatic general population
    Grazia Pennisi, Vito Di Marco, Carola Buscemi, Giovanni Mazzola, Cristiana Randazzo, Federica Spatola, Antonio Craxì, Silvio Buscemi, Salvatore Petta
    Journal of Gastroenterology and Hepatology.2021; 36(9): 2389.     CrossRef
  • Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts
    Jiwon Kim, Minyoung Lee, Soo Yeon Kim, Ji-Hye Kim, Ji Sun Nam, Sung Wan Chun, Se Eun Park, Kwang Joon Kim, Yong-ho Lee, Joo Young Nam, Eun Seok Kang
    Endocrinology and Metabolism.2021; 36(4): 823.     CrossRef
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    Toshihiro Niikura, Kento Imajo, Anna Ozaki, Takashi Kobayashi, Michihiro Iwaki, Yasushi Honda, Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Hiroyuki Kirikoshi, Satoru Saito, Atsushi Nakajima
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    Endocrinology and Metabolism.2019; 34(2): 179.     CrossRef
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    Pegah Golabi, Natsu Fukui, James Paik, Mehmet Sayiner, Alita Mishra, Zobair M. Younossi
    Hepatology Communications.2019; 3(8): 1050.     CrossRef
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    Beom-Jun Kim, Seong Hee Ahn, Seung Hun Lee, Seongbin Hong, Mark W. Hamrick, Carlos M. Isales, Jung-Min Koh
    Aging.2019; 11(13): 4547.     CrossRef
  • Implication of Nonalcoholic Fatty Liver Disease, Metabolic Syndrome, and Subclinical Inflammation on Mild Renal Insufficiency
    Ga Eun Nam, Soon Young Hwang, Hye Soo Chung, Ju Hee Choi, Hyun Jung Lee, Nam Hoon Kim, Hye Jin Yoo, Ji-A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi
    International Journal of Endocrinology.2018; 2018: 1.     CrossRef
  • Implication of liver enzymes on incident cardiovascular diseases and mortality: A nationwide population-based cohort study
    Kyung Mook Choi, Kyungdo Han, Sanghyun Park, Hye Soo Chung, Nam Hoon Kim, Hye Jin Yoo, Ji-A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Yong Gyu Park, Seon Mee Kim
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    Mariana Verdelho Machado
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  • Effect of statin on hepatocellular carcinoma in patients with type 2 diabetes: A nationwide nested case‐control study
    Gyuri Kim, Suk‐Yong Jang, Eugene Han, Yong‐ho Lee, Se‐young Park, Chung Mo Nam, Eun Seok Kang
    International Journal of Cancer.2017; 140(4): 798.     CrossRef
  • Clinical Characteristics of Non-Alcoholic Fatty Liver Disease Based on Analyses from the Kangbuk Samsung Health Study
    Eun-Jung Rhee
    The Journal of Korean Diabetes.2017; 18(2): 81.     CrossRef
  • Increased risk for development of coronary artery calcification in subjects with non-alcoholic fatty liver disease and systemic inflammation
    Jihyun Kim, Da Young Lee, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee, Susanne Kaser
    PLOS ONE.2017; 12(7): e0180118.     CrossRef
  • Articles inEndocrinology and Metabolismin 2016
    Won-Young Lee
    Endocrinology and Metabolism.2017; 32(1): 62.     CrossRef
  • Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases
    Eugene Han, Yong-ho Lee
    Diabetes & Metabolism Journal.2017; 41(6): 430.     CrossRef
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Obesity and Metabolism
Hemoglobin A1c Is Positively Correlated with Framingham Risk Score in Older, Apparently Healthy Nondiabetic Korean Adults
Ji Hye Shin, Ji In Kang, Yun Jung, Young Min Choi, Hyun Jung Park, Jung Hae So, Jin Hwa Kim, Sang Yong Kim, Hak Yeon Bae
Endocrinol Metab. 2013;28(2):103-109.   Published online June 18, 2013
DOI: https://doi.org/10.3803/EnM.2013.28.2.103
  • 3,829 View
  • 32 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Several studies have suggested that elevated levels of hemoglobin A1c (HbA1c) are associated with cardiovascular disease (CVD) in nondiabetic individuals. However, it is unclear whether HbA1c levels can serve as a simple screening marker for increased CVD risk in nondiabetic individuals. Our objective was to evaluate the relationship between HbA1c levels and CVD risk using the Framingham risk score (FRS) in older, apparently healthy nondiabetic Korean adults.

Methods

We retrospectively studied 2,879 Korean adults between the ages of 40 and 79 who underwent voluntary health check-ups at the Health Promotion Center of our hospital from July 2009 to June 2011. Subjects were subdivided based on their HbA1c levels into four groups: tertiles within the HbA1c normal tolerance range and a group for subjects with an increased risk for diabetes (IRD).

Results

The mean FRS for the upper tertile (9.6±3.8) group was significantly higher than that of the middle tertile (8.4±4.0) and lower tertile (7.6±3.8) groups. In addition, FRS was highest in the IRD group (10.5±3.7). Multiple linear regression analysis demonstrated that HbA1c levels exhibited a significant positive correlation with FRS when adjusted for confounding variables in all subjects (β±standard error [SE], 0.018±0.002; R2, 0.131), women (β±SE, 0.023±0.003; R2, 0.170), and men (β±SE, 0.016±0.004; R2, 0.109).

Conclusion

HbA1c levels were positively correlated with FRS in older, apparently healthy nondiabetic Korean adults. We propose that HbA1c levels may reflect CVD risk in nondiabetic individuals.

Citations

Citations to this article as recorded by  
  • Correlation between cardiovascular risk and glycemic control among patients with diabetes
    Naomi Niari Dalimunthe, Herwindo Ahmad, Dina Arwina Dalimunthe
    MGM Journal of Medical Sciences.2024; 11(1): 44.     CrossRef
  • Framingham Risk Score Assessment in Subjects with Pre-diabetes and Diabetes: A Cross-Sectional Study in Korea
    Hyuk Sang Kwon, Kee Ho Song, Jae Myung Yu, Dong Sun Kim, Ho Sang Shon, Kyu Jeung Ahn, Sung Hee Choi, Seung Hyun Ko, Won Kim, Kyoung Hwa Lee, Il Seong Nam-Goong, Tae Sun Park
    Journal of Obesity & Metabolic Syndrome.2021; 30(3): 261.     CrossRef
  • Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
    Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
    Diabetes & Metabolism Journal.2017; 41(3): 187.     CrossRef
  • Randomized, Open-Label, Parallel Group Study to Evaluate the Effect of Internet-Based Glucose Management System on Subjects with Diabetes in China
    Hun-Sung Kim, Chenglin Sun, So Jung Yang, Lin Sun, Fei Li, In Young Choi, Jae-Hyoung Cho, Guixia Wang, Kun-Ho Yoon
    Telemedicine and e-Health.2016; 22(8): 666.     CrossRef
  • GA to HbA1C ratio, but not HbA1C is associated with cognition in Chinese nondiabetic old adults
    Yuan Zhong, Jun Jin, Chan Chan Xu, Guo Xiang Fu
    Aging & Mental Health.2015; 19(9): 853.     CrossRef
  • Relationship of Glycated Hemoglobin A1c, Coronary Artery Calcification and Insulin Resistance in Males Without Diabetes
    Chan-Hee Jung, Eun-Jung Rhee, Kyu-Jin Kim, Bo-Yeon Kim, Se Eun Park, Yoosoo Chang, Seungho Ryu, Cheol-Young Park, Ji-Oh Mok, Ki-Won Oh, Chul-Hee Kim, Sung-Woo Park, Sung-Koo Kang, Won-Young Lee
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    Mi-Kyeong Choi, Yun-Jung Bae
    The Korean Journal of Food And Nutrition.2014; 27(3): 484.     CrossRef
  • Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
    Won-Young Lee
    Endocrinology and Metabolism.2014; 29(3): 251.     CrossRef
  • Suicidal ideation and suicide attempts among diabetes mellitus: The Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012
    Jae Ho Chung, Kitae Moon, Do Hyung Kim, Joo-Won Min, Tae Ho Kim, Hee-Jin Hwang
    Journal of Psychosomatic Research.2014; 77(6): 457.     CrossRef
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