Table 2.
Association between non-invasive biomarkers (NAFL, NASH, and NASH-related fibrosis) and cardiovascular outcomes
| Biomarker | Population/dataset | Country | CVD relationship |
|---|---|---|---|
| NAFL | |||
| Fatty Liver Index | Adults without CVD [17] | Republic of Korea | Cardiovascular mortality, non-fatal MI, CVA |
| KNHIS [18] | Republic of Korea | HF incidence, HF hospitalization | |
| Chinese Kadoorie Biobank [19] | China | MI, CVA | |
| Hepatic Steatosis Index | Adults without CVD [21] | Republic of Korea | FRS |
| NAFLD Liver Fat Score | NHANES 1988–1994 [23] | USA | Cardiovascular mortality |
| NHANES 1999–2016 [24] | USA | CAD, CHF, angina, cardiovascular mortality | |
| KNHANES 2008–2011 [25] | Republic of Korea | ACC/AHA PCE | |
| Triglyceride-Glucose Index | PURE [28] | Various | MI, CVA |
| NAFLD patients with chest pain [29] | China | Gensini Score, CAD | |
| NASH | |||
| CK-18 | Adults without chronic liver disease [33] | China | Incidence of cardiometabolic disease |
| WELCOME [34] | UK | CIMT progression | |
| PREVEND [35] | The Netherlands | SCORE | |
| Post-MI patients [36] | Turkey | LV remodeling | |
| Hs-CRP | Patients with prior MI [39] | Sweden | MACE |
| Patients with NAFLD [40] | Republic of Korea | CAC | |
| Patients without CVD [41] | Taiwan | FRS | |
| NHANES 1988–1994 [42] | USA | Cardiovascular mortality | |
| TNF-α | Danish Research Center for Prevention and Health [45] | Denmark | Non-fatal MI, CAD mortality |
| IL-6 | MESA [48] | USA | CAD prevalence and severity |
| aPAI1 | Framingham Heart Study [55] | USA | MACE |
| Arachidonic-acid derived lipid mediators | Patients with prior MI [59] | Taiwan | Recurrent MI |
| FGF-21 | Patients with NAFLD and/or CAD [62] | China | CAD prevalence |
| Shanghai Diabetes Study [63] | China | ASCVD prevalence | |
| Systemic review of 28 studies [64] | Various | Cardiovascular mortality, CAD incidence | |
| Guangdong Coronary Artery Disease Cohort [65] | China | Cardiovascular mortality | |
| NASH-related fibrosis | |||
| Fibrosis-4 Index | Asymptomatic adults with NAFLD [68] | Republic of Korea | CAC progression |
| NAFLD patients without CVD [83] | Republic of Korea | CAC progression | |
| Patients with CVD [69] | Japan, China, USA, Germany | Cardiovascular mortality | |
| Patients with MAFLD [70] | Republic of Korea | ACC/AHA PCE | |
| Patients with MAFLD [71] | Iran | CAD | |
| NAFLD Fibrosis Score | Asymptomatic adults with NAFLD [68] | Republic of Korea | CAC progression |
| NAFLD patients without CVD [83] | Republic of Korea | CAC progression | |
| Patients with CVD [69] | Japan, China, USA, Germany | Cardiovascular events, cardiovascular mortality | |
| Patients with NAFLD [81] | Italy | FRS, Progetto CUORE, SCORE | |
| Patients with MAFLD [70] | Republic of Korea | ACC/AHA PCE | |
| BARD Score | Patients with NAFLD [81] | Italy | FRS, Progetto CUORE, SCORE |
| KNHIS [18] | Republic of Korea | HF incidence, HF hospitalization, cardiovascular mortality | |
| AST to Platelet Ratio Index | NAFLD patients without CVD [83] | Republic of Korea | CAC progression |
| Patients with NAFLD [81] | Italy | FRS, Progetto CUORE, SCORE | |
| Forns Index | NAFLD patients without CVD [83] | Republic of Korea | CAC progression |
| Patients with NAFLD [81] | Italy | Framingham risk score, Progetto CUORE, SCORE | |
| Hepamet Fibrosis Score | Patients with NAFLD [81] | Italy | Framingham risk score, Progetto CUORE, SCORE |