A meta-analysis on the global prevalence, risk factors and screening of coronary heart disease in nonalcoholic fatty liver disease
Abstract
Background & aims Cardiovascular disease remains the leading cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors, particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors, and influence of steatosis grade on manifestation of CHD among patients with NAFLD.Methods Two databases, Embase and Medline, were utilized to search for articles relating to NAFLD and CHD. Data including, but not limited to, continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted.Results Of the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (95% confidence interval [CI], 36.0%-53.6%) among 67,070 patients with NAFLD with an odds ratio of 1.33 (95% CI, 1.21%-1.45%; P < .0001). The prevalence of CHD was higher in patients with moderate to severe steatosis (37.5%; 95% CI, 15.0%-67.2%) than those with mild steatosis (29.6%; 95% CI, 13.1%-54.0%). The pooled prevalence of subclinical and clinical CAD was 38.7% (95% CI, 29.8%-48.5%) and 55.4% (95% CI, 39.6%-70.1%), respectively.Conclusion Steatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD.
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Individuals with MASLD have a higher risk of coronary heart disease (OR 1.33).
“coronary heart disease (odds ratio [OR] 1.33), 28”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [28]
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Flagged first, then by citations
Cited by
Sorted by citations
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
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Jang, W., & Song, J. S. (2023) · Diagnostics · doi:10.3390/diagnostics13111852 · Cited by 55 · see citing works
- Authors
- Toh, J. Z. K., Pan, X.-H., Tay, P. W. L., Ng, C. H., Yong, J. N., Xiao, J., Koh, J. H., Tan, E. Y., Tan, E. X. X., Dan, Y. Y., Loh, P. H., Foo, R., Chew, N. W. S., Sanyal, A. J., Muthiah, M. D., & Siddiqui, M. S.
- Affiliations
- National University of Singapore (SG)
- National University Heart Centre Singapore (SG)
- Virginia Commonwealth University (US)
- Corresponding author
- Muthiah, Mark D.
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-11
- Volume
- 20
- Issue
- 11
- Pages
- 2462-2473.e10
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W3201136001
- Cited by
- 130
- References
- 107
- Citations by year
- 2026: 19 · 2025: 23 · 2024: 25 · 2023: 34 · 2022: 28 · 2021: 1
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Gilead Sciences
- Bristol-Myers Squibb
- Novartis
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- non-alcoholic fatty liver disease, coronary artery disease, cardiovascular risk, steatosis grade, subclinical coronary artery disease, prevalence, risk factors, cardiovascular screening
- MeSH terms
- Coronary Artery Disease, Humans, Risk Factors, Prevalence, Odds Ratio, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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