OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) and sarcopenia have a close association with an increased risk of atherosclerotic cardiovascular disease (ASCVD). This study investigated the influence of NAFLD and sarcopenia on ASCVD risk. METHODS Data from the 2008-2011 Korean National Health and Nutrition Examination Surveys database were analyzed (n = 7,191). The sarcopenia index was calculated using dual-energy x-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cutoffs = 0.882 for men and 0.582 for women). NAFLD was defined as a comprehensive NAFLD score ≥40. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk >10%. RESULTS The prevalence rates of NAFLD and sarcopenia were 31.2% (n = 2,241) and 19.5% (n = 1,400), respectively. The quartile-stratified ASCVD risk scores were positively associated with NAFLD and sarcopenia (all P for trend < 0.001). Subjects with both NAFLD and sarcopenia had a higher risk for high probability of ASCVD (odds ratio = 1.83, P = 0.014) compared with controls without NAFLD and sarcopenia. Among subjects with NAFLD, FIB-4-defined significant liver fibrosis and sarcopenia additively raised the risk for high probability of ASCVD (odds ratio = 3.56, P < 0.001) compared with controls without FIB-4-defined significant liver fibrosis or sarcopenia. DISCUSSION NAFLD and sarcopenia were significantly associated with an increased risk of ASCVD in the general population. In addition, NAFLD with significant liver fibrosis and sarcopenia were significantly associated with an increased risk of ASCVD in subjects with NAFLD.

中文翻译：

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非酒精性脂肪肝和肌肉减少症与心血管风险独立相关

目的 非酒精性脂肪肝 (NAFLD) 和肌肉减少症与动脉粥样硬化性心血管疾病 (ASCVD) 的风险增加密切相关。本研究调查了 NAFLD 和肌肉减少症对 ASCVD 风险的影响。方法 分析了 2008-2011 年韩国国家健康和营养调查数据库中的数据（n = 7,191）。肌肉减少症指数是使用双能 X 射线吸收测定法计算的。肌肉减少症被定义为最低五分之一的肌肉减少症指数值（男性为 0.882，女性为 0.582）。NAFLD 定义为 NAFLD 综合评分≥40。使用纤维化 4 (FIB-4) 指数评估肝纤维化。使用美国心脏病学会/美国心脏协会指南评估 ASCVD 风险。ASCVD 的高概率定义为 ASCVD 风险 >10%。结果 NAFLD 和肌肉减少症的患病率分别为 31.2% (n = 2,241) 和 19.5% (n = 1,400)。四分位数分层的 ASCVD 风险评分与 NAFLD 和肌肉减少症呈正相关（所有 P 趋势 < 0.001）。与没有 NAFLD 和肌肉减少症的对照组相比，同时患有 NAFLD 和肌肉减少症的受试者患 ASCVD 的可能性更高（比值比 = 1.83，P = 0.014）。在患有 NAFLD 的受试者中，与没有 FIB-4 定义的显着肝纤维化或肌肉减少症的对照相比，FIB-4 定义的显着肝纤维化和肌肉减少症增加了 ASCVD 高概率的风险（比值比 = 3.56，P < 0.001）。讨论 在一般人群中，NAFLD 和肌肉减少症与 ASCVD 风险增加显着相关。此外，