Diabetes, Metabolic Syndrome and Obesity (Sep 2019)
The interplay between abdominal aortic aneurysm, metabolic syndrome and fatty liver disease: a retrospective case-control study
Abstract
Mahmud Mahamid1,2, Tawfik Khoury2,3, Baker Mahamid1, Wisam Sbeit2,3, Amir Mari1, Wiliam Nseir2,4 1Gastroenterology and Hepatology Unit, Nazareth Hospital EMMS, Nazareth, Israel; 2Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; 3Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel; 4Internal Medicine Department, Nazareth Hospital EMMS, Nazareth, IsraelCorrespondence: Mahmud MahamidDivision of Internal Medicine, Gastroenterology and Endoscopy Unit, EMMS, the Nazareth Hospital, Nazareth 16100, IsraelTel +972 4 602 8851Fax +972 74 755 9051Email [email protected]: Abdominal aortic aneurysm (AAA) and fatty liver disease are both associated with the metabolic syndrome (MS); the aim of this study was to investigate whether patients with AAA are also at a higher risk for fatty liver disease.Methods: A case-control retrospective study. Patients diagnosed with AAA were compared with age- and sex-matched controls regarding the prevalence of fatty liver disease. Extracted data include anthropometric parameters, clinical and laboratory data, and liver imaging.Results: 995 patients were enrolled in the final analysis, 495 patients with AAA and 500 age- and sex-matched controls. The prevalence of fatty liver disease among AAA subjects was 48.9% compared with 21.2% among the controls (P<0.005). After adjusting for age, smoking, body mass index, and MS components, the logistic regression analysis indicates that AAA (men: OR 1.29, 95% CI 1.17, 1.49, P=0.001; women: OR 1.23, 95% CI 1.06, 1.43, P=0.002), obesity (men: OR 1.32, 95% CI 1.17, 1.59, P<0.001; women: OR 1.32, 95% CI 1.07, 1.52, P=0.012), hypertension (men: OR 1.23, 95% CI 1.13, 1.46, P=0.001; women: OR 1.13, 95% CI 1.00, 1.33, P=0.045), MS (men: OR 1.31, 95% CI 1.19, 1.53, P=0.001; women: OR 1.28, 95% CI 1.16, 1.42, P=0.002) were associated with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH). The prevalence of liver cirrhosis was 1.23%; subjects with obesity, diabetes, hypertension, and AAA had increased risk for cirrhosis (OR 1.89, 95% CI 1.18, 3.22, P=0.014; OR 1.27, 95% CI 1.09, 2.72, P=0.0027; OR 2.08, 95% CI 1.29, 3.42, P=0.004; OR 1.73, 95% CI 1.08, 2.87, P=0.027, respectively).Conclusion: AAA patients are at increased risk for NAFLD/NASH, may predict advance liver disease and liver cirrhosis.Keywords: fatty liver, abdominal aortic aneurysm, metabolic syndrome