Risk of ischemic heart disease in patients with non-alcoholic fatty liver disease (Original Article/ Case Control Study)

Background and study objective: The global prevalence of non-alcoholic fatty liver disease (NAFLD) is on the rise. It is strongly associated with metabolic syndrome (MetS), and together, they may contribute to the development of ischemic heart disease (IHD). Aim: To investigate the potential role of NAFLD and its frequent association with MetS in developing IHD. Subjects and methods: The study included 60 patients with NAFLD and 30 control subjects. Comprehensive laboratory evaluations were conducted for all participants, including fasting blood glucose, lipid profile, liver enzyme levels, and liver virology. NAFLD was diagnosed, and its severity was graded using ultrasonography. MetS was identified based on standard diagnostic criteria. IHD was evaluated through electrocardiography (ECG), echocardiography, stress ECG, and coronary angiography. Results: In the NAFLD group, 20 cases were selected for each NAFLD grade. Among the NAFLD group, the prevalence of MetS increased with disease severity: 6 cases (10.0%) in Grade I, 11 cases (18.3%) in Grade II, and 16 cases (26.7%) in Grade III, compared to 3 cases (10.0%) in the control group. IHD prevalence increased from 5 cases (8.3%) in Grade I to 6 cases (10.0%) in Grade II and 10 cases (16.6%) in Grade III, compared to 4 cases (13.3%) in the control group. Conclusion: NAFLD is an independent risk factor for an increased likelihood of myocardial ischemia, with increasing risk when MetS exists. The higher the grade of NAFLD, the higher the risk of IHD.