Association between Atrial Fibrillation and Advanced Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
Min Kyu Kang, Jung Gil Park, Min Cheol Kim
Abstract
Purpose: Non-alcoholic fatty liver disease (NAFLD) is independently associated with the development of atrial fibrillation (AF).However, the association of AF with advanced liver fibrosis, which is related to all-cause, cardiovascular, and liver-related mortality, has not been established in NAFLD patients.We aimed to investigate the association between AF and advanced liver fibrosis in NAFLD patients.Materials and Methods: Out of 53704 adults who participated in the health check-up program, 6293 subjects aged 35 years and older were diagnosed as NAFLD using ultrasound.The stage of liver fibrosis was assessed based on the newly adjusted NAFLD fibrosis score (NFS) and Fibrosis-4 (Fib-4) Index, which were used to determine the low and high cut-off values (COVs).Results: Of 6293 patients with NAFLD, 59 (0.9%) were diagnosed with AF.Patients with AF were older (52.0 vs. 64.6 years, p< 0.001), had higher body mass index (25.2 vs. 26.6 kg/m 2 , p<0.001), and had bigger waist circumference (84.0 vs. 89.9cm, p<0.001) than those without AF.In NAFLD patients, AF was independently associated with advanced liver fibrosis, assessed using both COVs of NFS [low-COV group: final adjusted odds ratios (aORs)=2.85,p=0.004; high-COV group: ORs=12.29,p<0.001).AF was independently associated with advanced liver fibrosis, assessed using both COVs of Fib-4 (low-COV group: aORs=2.49,p<0.001; high-COV group: aORs=3.84,p=0.016).Conclusion: AF is independently associated with advanced liver fibrosis in patients with NAFLD.