Association between Inflammatory Markers and Liver Fat: The Multi-Ethnic Study of Atherosclerosis
|Yasmin S. Hamirani1*, Ronit Katz2, Khurram Nasir3, Irfan Zeb4, Michael J. Blaha3, Roger S. Blumenthal3, Richard N. Kronmal2 and Matthew J. Budoff5|
|1CardiovascularImaging Fellow, Los Angeles Biomedical Research Institute at Harbor-UCLA, CA, USA|
|2Department of Medicine, University of Washington, Seattle, WA, USA|
|3Department of Medicine, Ciccarone Center for Preventive Cardiology, Johns Hopkins University, Baltimore, MD, USA|
|4Resident in Internal Medicine, Johns Hopkins University, Baltimore, MD, USA|
|5Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-ULCA, Torrance, CA, USA|
|Corresponding Author :||Yasmin Hamirani
1124 West Carson Street, Torrance, CA, 90502, USA
E-mail: [email protected]
|Received August 21, 2013; Accepted October 25, 2014; Published November 05, 2014|
|Citation: Hamirani YS, Katz R, Nasir K, Zeb I, Blaha MJ,et al. (2014) Association between Inflammatory Markers and Liver Fat: The Multi-Ethnic Study of Atherosclerosis. J Clin Exp Cardiolog 5:344. doi:10.4172/2155-9880.1000344|
|Copyright: © 2014 Hamirani YS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease. Data is emerging that an independent association between markers of subclinical atherosclerosis and NAFLD exists and it may be considered as an independent predictor of cardiovascular (CV) outcomes. We aim to better characterize the relationship between NAFLD and inflammatory markers in a multi-ethnic cohort by assessing fatty liver on computed tomography (CT) scans.
Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal, population-based study from four ethnic groups free of CV disease at baseline. The inflammatory markers studied include: C-reactive protein (CRP) and interleukin 6 (IL-6). On CT scans liver-to-spleen ratio (LSR: Hounsfield Units (HU) of the liver divided by HU of spleen) of <1 and liver attenuation of <40 HU were used as criteria for fatty liver. Unadjusted and adjusted multivariate linear and logistic regression analysis was performed.
Results: 4038 participants amongst 6814 MESA population with visible spleen on the CT scan, available CRP and IL-6 levels and no reported liver cirrhosis were included. The average age was 61 ± 10 years, 37% Caucasians and 45% were males. Mean CRP and IL-6 were 2.36 mg/dl and 1.37 pg/ml respectively. 696 participants (17%) had LSR of <1 and 253 (6%) had liver attenuation of <40 HU. When using LSR<1 as a continuous variable, the correlation (adjusted odds ratio (OR) with CRP>2.0 was 0.037 (95% CI: 0.02-0.054) and with IL-6 was 0.014 (95% CI: 0.004-0.023). On the other hand when presence and absence of LSR<1 was considered, higher ORs for association with CRP>2:1.41 (95% CI: 1.16 to 1.73) and IL6:1.18 (95% CI: 1.05 to 1.31) were found. Similarly, the adjusted association of per unit decrease in liver attenuation with CRP>2 was 1.92 (95% CI: 1.20 to 2.63) while for IL-6 was 1.08 (95% CI: 0.69 to 1.47). When considering presence and absence of liver attenuation <40 HU the OR for CRP>2 was 2.27 (95% CI: 1.62 to 3.16) and for IL-6 was 1.33 (95% CI: 1.13 to 1.58).
Conclusion: CRP and IL-6 levels were found to be significantly associated with liver fat assessed on CT scan after adjusting for other risk factors for atherosclerosis.