A Meta-Analysis on the Global Prevalence, Risk factors and Screening of Coronary Heart Disease in Non-alcoholic Fatty Liver Disease.

ABSTRACT Background and Aims Cardiovascular disease remains the leading cause of death in patients with non-alcoholic fatty liver disease (NAFLD). Studies examining the association of coronary heart disease (CHD) and NAFLD are cofounded by various cardiometabolic factors particularly diabetes and body mass index. Hence, we seek to explore such association by investigating the global prevalence, independent risk factors and influence of steatosis grade on manifestation of CHD among patients with NAFLD. Methods Two databases, Embase and Medline, were utilised to search for articles relating to NAFLD and CHD. Data including but not limited to continent, diagnostic methods, baseline characteristics, prevalence of CHD, CHD severity, NAFLD severity, and risk factors were extracted. Results Of the 38 articles included, 14 reported prevalence of clinical coronary artery disease (CAD) and 24 subclinical CAD. The pooled prevalence of CHD was 44.6% (CI: 36.0% - 53.6%) among 67,070 NAFLD patients with an odds ratio of 1.33 (CI: 1.21% - 1.45%, p Conclusion Steatosis was found to be related with CHD involvement, with moderate to severe steatosis related to clinical CAD. Early screening and prompt intervention for CHD in NAFLD are warranted for holistic care in NAFLD.