. 2012 Oct 12;4(1):137–140. doi: 10.1136/heartasia-2012-010167

Table 4.

Published studies of the risk of cardiovascular disease (CVD) or related mortality associated with non-alcoholic fatty liver disease (NAFLD) or an elevated alanine aminotransferse (ALT)

Year (reference)	Study design	Total participants analysed (n)	Baseline method of assessment of NAFLD	Cardiovascular disease study outcome	Adjusted risk (95% CI) for study outcome comparing presence versus absence of NAFLD
2006¹⁴	Cross-sectional analysis	7526	Elevated serum ALT >43 IU/l	10-y coronary heart disease (CHD) risk by Framingham Risk Score	• adjusted HR men 1.3 (1.2 to 1.5)
2007⁶	Prospective cohort study	1439	Upper tertileserum ALT	• 10-y all-cause mortality	• HR women 2.1 (1.5 to 3.0)
				• Fatal and non-fatal CVD	• HR 1.3 (0.92 to 1.8)
				• Fatal and non-fatal CHD	• HR 1.4 (1.1 to 1.8)
					• HR 2.0 (1.4 to 3.1)
2005¹⁵	Prospective nested case-control study	744	Ultrasound findings of hepatic steatosis	Incidence of CVD event within 5-year follow-up in patients with DM2	OR 1.6 (1.2 to 1.9)
2007¹⁶	Prospective observational cohort study	1221	Ultrasound findings of hepatic steatosis	Incidence of CVD within a 5-year follow-up without DM2	OR 4.1 (1.6 to 10.8)
2008¹⁷	Prospective cohort study	37085	Elevated serum ALT >31 IU/l	CVD- or diabetes-related mortality	RR 2.3 (1.0 to 5.1)
2011¹⁸	Cross-sectional study	303	Elevated serum ALT ≥95th centile	Acute ischemic stroke	OR 3.3 (1.3 to 8.4)
Current	Prospective cohort study	528	Elevated serum ALT ≥90th centile	• Maximum measured cardiac troponin concentration at 24 h	• OR 7.1 (1.8 to 27.4)
				• All-cause mortality in-hospital	• OR 10.8 (3.6 to 32.4)
				• All-cause mortality in-hospital and ≤6 months	• OR 9.0 (3.3 to 24.5)
				• Composite of myocardial infarction, stroke, re-hospitalisation or all-cause mortality ≤6 months	• OR 2.7 (1.1 to 6.6)

CHD, coronary heart disease; CVD, cardiovascular disease; DM2, type 2 diabetes mellitus; RR, adjusted relative risk.