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Association between Atrial Fibrillation and Advanced Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease

Yonsei Medical Journal 2020년 61권 10호 p.860 ~ 867
강민규, 박정길, 김민철,
소속 상세정보
강민규 ( Kang Min-Kyu ) - Yeungnam University College of Medicine Department of Internal Medicine
박정길 ( Park Jung-Gil ) - Yeungnam University College of Medicine Department of Internal Medicine
김민철 ( Kim Min-Cheol ) - Yeungnam University College of Medicine Department of Internal Medicine

Abstract


Purpose: Non-alcoholic fatty liver disease (NAFLD) is independently associated with the development of atrial fibrillation (AF). However, the association of AF with advanced liver fibrosis, which is related to all-cause, cardiovascular, and liver-related mortality, has not been established in NAFLD patients. We aimed to investigate the association between AF and advanced liver fibrosis in NAFLD patients.

Materials and Methods: Out of 53704 adults who participated in the health check-up program, 6293 subjects aged 35 years and older were diagnosed as NAFLD using ultrasound. The stage of liver fibrosis was assessed based on the newly adjusted NAFLD fibrosis score (NFS) and Fibrosis-4 (Fib-4) Index, which were used to determine the low and high cut-off values (COVs).

Results: Of 6293 patients with NAFLD, 59 (0.9%) were diagnosed with AF. Patients with AF were older (52.0 vs. 64.6 years, p<0.001), had higher body mass index (25.2 vs. 26.6 kg/m2,p<0.001), and had bigger waist circumference (84.0 vs. 89.9 cm, p<0.001) than those without AF. In NAFLD patients, AF was independently associated with advanced liver fibrosis, assessed using both COVs of NFS [low-COV group: final adjusted odds ratios (aORs)=2.85, p=0.004; high-COV group: ORs=12.29, p<0.001). AF was independently associated with advanced liver fibrosis, assessed using both COVs of Fib-4 (low-COV group: aORs=2.49, p<0.001; high-COV group: aORs=3.84, p=0.016).

Conclusion: AF is independently associated with advanced liver fibrosis in patients with NAFLD.

키워드

Atrial fibrillation; fibrosis; metabolic syndrome; non-alcoholic fatty liver disease

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