Development of Coronary Heart Disease and Cerebral Stroke in Japanese Elderly Patients with Nonalcoholic Fatty Liver Diseases

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  • Ogawa Kyoko
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Ohmoto-Sekine Yuki
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Hara Shigeko
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Okuda Chikao
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Amakawa Kazuhisa
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Arimoto Satao
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Kato Hisahito
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Dong Hsieh Shiun
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Tanabe Maho
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Ogata Chie
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Ishihara Makiko
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Tsuji Hiroshi
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital
  • Saito Kazumi
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine
  • Kodama Satoru
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine
  • Sone Hirohito
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine
  • Arase Yasuji
    Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital

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Abstract

Objective: Metabolic syndrome enhances coronary heart disease and cerebral stroke. However, few longitudinal studies have been conducted on the incidence of coronary heart disease and cerebral stroke in Japanese patients with non-alcoholic fatty liver disease (NAFLD) and the risk factors for its development. <br>Methods: A total of 1,798 NAFLD patients with an age of ≥60 years were enrolled. The primary event was the first onset of coronary heart disease or cerebral stroke. Independent factors associated with the incidence rate of such events were analyzed by the Kaplan-Meyer method and the Cox proportional hazard model. The mean observation period was 7.5 years.<br>Results: The number of cases of coronary heart disease or cerebral stroke that developed was 137. The 10th year cumulative development rate was 11.7% in the NAFLD patients. Cox proportional hazards analysis revealed the following: 1) Coronary heart disease occurred with statistical significance when patients had poor control of blood pressure, smoking, low high density lipoprotein level, and high glucose level. 2) Ischemic stroke occurred with statistical significance when patients had poor control of blood pressure, an age of ≥70 years, and high glucose level. 3) Hemorrhagic stroke occurred with statistical significance when patients had poor control of blood pressure, age ≥70 years, low albumin level of <3.9 g/dL and high aspartate aminotransferase to platelet ratio index. <br>Conclusion: Our study indicates that the risk factors for the development of vascular disease are different for coronary heart disease, ischemic stroke and hemorrhagic stroke in Japanese elderly patients with NAFLD.

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