Z Gastroenterol 2018; 56(05): e44-e45
DOI: 10.1055/s-0038-1654651
POSTER
Hepatologie
Georg Thieme Verlag KG Stuttgart · New York

Histological severity is related to cardiovascular events in lean but not in overweight and obese subjects with NAFLD

A Feldman
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
L Denkmayr
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
M Strasser
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
S Ruhaltinger
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
G Strebinger
2   Hospital Oberndorf, Department of Internal Medicine, Oberndorf, Austria
,
U Huber-Schönauer
2   Hospital Oberndorf, Department of Internal Medicine, Oberndorf, Austria
,
D Niederseer
2   Hospital Oberndorf, Department of Internal Medicine, Oberndorf, Austria
,
L Stechemesser
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
S Zandanell
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
B Paulweber
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
C Datz
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
,
E Aigner
1   First Department of Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
09 May 2018 (online)

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Background and aims:

Non-alcoholic fatty liver disease (NAFLD) typically affects obese subjects. Fatty liver is a known risk factor for cardiovascular diseases. We aimed to investigate the baseline characteristics of lean NAFLD subjects who subsequently developed cardiovascular events.

Methods:

464 patients had received the clinical and histological diagnosis of NAFLD at our two centres between 1997 and 2014 of whom 353 (76.1%) were available for follow-up after 8.8 (1 – 19) years. They were allocated to one of 3 groups according to BMI at the time of the liver biopsy: lean (BMI ≤25 kg/m, N = 48), overweight (BMI 25 – 30 kg/m2, N = 195) and obese (BMI ≥30 kg/m2, N = 110). A specific analysis with regard to cardiovascular events was performed.

Results:

In 135 (38.2%) subjects a cardiovascular event had occurred, in 19 (39.6%) lean, 67 (34.3%) overweight and 49 (44.5%) obese subjects. In lean subjects with cardiovascular events, a higher degree of perisinusoidal fibrosis (P < 0.001; P = 0.011) and steatosis (P = 0.016; P = 0.001) were reported compared to obese and overweight subjects with cardiovascular events. Further, lean subjects with cardiovascular events had a higher degree of ballooning (p = 0.001) and periportal fibrosis (p = 0.01) in comparison to overweight subjects with events. Framingham Risk Score at baseline was higher in each BMI group comparing subjects with to those without an event (p < 0.01 for all groups) and was similar comparing all subjects with events among all BMI categories.

Conclusions:

Cardiovascular events in lean subjects were related to more pronounced histological changes such as ballooning and fibrosis, while no such link was observed in overweight and obese subjects. Likewise, fibrosis was also linked to cardiovascular disease among lean subjects. These findings suggest that histological severity may be particularly linked to cardiovascular events in lean NAFLD subjects.