NAFLD Increases CV Risk in Women

Women with nonalcoholic fatty liver disease (NAFLD) have a higher risk for cardiovascular (CV) events, according to a recent study presented at the American Association for the Study of Liver Diseases’ 2017 Liver Meeting.

In their study, the researchers identified 4196 adults diagnosed with NAFLD in Olmsted County, Minnesota from 1997 through 2014 using the Rochester Epidemiology Project database (median age 52 years, 52% were women). They identified incident CV events, which included angina, myocardial infarction, heart failure, atrial fibrillation, and stroke, following a NADFLD diagnosis. Using cox regression, the researchers analyzed the risk for CV events in men and women with NAFLD compared with 15,786 controls from the general population matched for age, gender, diabetes, hypertension, hyperlipidemia, and stratified for baseline cardiovascular disease.
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During a median follow-up of 7 years, 1684 CV events were observed.

Women with NAFLD had a higher risk of CV events compared with those without NAFLD (hazard ratio [HR] 1.21). However, the risk for CV events was not different between men with and without NAFLD (HR 1.08).

Among women, NAFLD was associated with an increased risk for angina (HR 1.55), myocardial infarction (HR 1.33), and heart failure (HR 1.31), but not atrial fibrillation or stroke. CV events occurred at younger ages among women with NAFLD compared with women and men without NAFLD.  

In addition, the researchers found that the protective effects of the female sex on CV events decreased to 13% among women with NAFLD from 24% among general population women.

“NAFLD is associated with significantly higher incidence of subsequent CV events in women, but not in men. Compared to the general population, the CV events manifest at younger age,” the researchers concluded. “These findings suggest that CV risk stratification in NAFLD should consider sex-related differences, as women may require more aggressive preventative measures to avoid worse CV outcomes.”

—Melissa Weiss

Reference:

Allen AM, Kamath PS, Larson JJ, Watt KD, Hayes SN, Therneau TM. Cardiovascular risk in NAFLD- not an equal opportunity: implications for women's health. Presented at: AASLD Liver Meeting 2017; October 20-24, 2017; Washington, DC. Abstract 55.