Performance of nonalcoholic fatty liver fibrosis score in estimating atherosclerotic cardiovascular disease risk

Background and aims: It is currently unclear whether the nonalcoholic fatty liver dis-ease (NAFLD) fibrosis score, when compared to major anthropometric indices, is useful in esti-mating the risk of atherosclerotic cardiovascular disease (ASCVD).Methods and results: This study included 3886 adults undergoing a health checkup. An elevated risk of ASCVD was determined as a 10-year ASCVD risk >= 7.5% using Pooled Cohort Equations. NAFLD was diagnosed with abdominal ultrasonography. Receiver operating characteristic curves were used to evaluate the performance of estimating an elevated ASCVD risk. Among study par-ticipants, 521 (13.4%) had an elevated ASCVD risk and 1473 (37.9%) had NAFLD. Subjects with NAFLD had a significantly higher rate of ASCVD risk >= 7.5% (p < 0.001) compared to those without NAFLD. After adjusting for cardiometabolic risk factors, NAFLD (OR = 1.49, 95% CI: 1.10-2.00, p = 0.009) in all participants and NAFLD fibrosis score >0.676 (OR = 1.95, 95% CI: 1.30-2.92, p = 0.001) in individuals with NAFLD were significantly associated with an elevated risk of ASCVD. When compared to different anthropometric indices, NAFLD fibrosis score exhibited the largest area under the curve (AUC) in individuals with NAFLD (AUC = 0.750) in estimating an elevated ASCVD risk. Furthermore, NAFLD fibrosis score displayed the best predictive perfor-mance for identifying an elevated ASCVD risk in male participants with NAFLD (AUC = 0.737).Conclusion: NAFLD was a significant risk factor for elevated ASCVD risk. NAFLD fibrosis score >0.676 was associated with increased ASCVD risk in individuals with NAFLD. Compared with anthropometric indices, NAFLD fibrosis score demonstrated the best performance in estimating elevated ASCVD risk among those with NAFLD.(c) 2023 Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clin-ical Medicine and Surgery, Federico II University.

Automated summary

NAFLD was a significant risk factor for an elevated ASCVD risk. NAFLD fibrosis score >0.676 was associated with increased ASCVD risk in individuals with NAFLD. When compared to anthropometric indices, NAFLD fibrosis score demonstrated the best performance in estimating an elevated ASCVD risk among those with NAFLD.