Journal of Gastroenterology

, Volume 54, Issue 3, pp 271–280 | Cite as

Clinical significance of hepatic steatosis according to coronary plaque morphology: assessment using controlled attenuation parameter

  • Hyo Eun Park
  • Heesun Lee
  • Su-Yeon Choi
  • Min-Sun Kwak
  • Jong In Yang
  • Jeong Yoon Yim
  • Goh Eun ChungEmail author
Original Article—Liver, Pancreas, and Biliary Tract



Nonalcoholic fatty liver disease (NAFLD) plays a significant role in coronary atherosclerosis, independent of shared metabolic risk factors. The measurement of the controlled attenuation parameter (CAP) has shown to allow early and noninvasive detection of NAFLD at subclinical stage. We evaluated the significance of CAP-defined NAFLD in association with the presence of any type of coronary plaques and different plaque compositions.


We conducted a retrospective cohort of apparently healthy subjects who had liver Fibroscan and coronary computed tomography during health screening exams.


A greater number of subjects with CAP-defined NAFLD was found in group with coronary plaques (61.3% vs. 73.5%, p = 0.005 without vs. with any type of plaque). From multivariate regression model, CAP ≥ 222 dB/m was an independent and significant parameter associated with the presence of coronary plaques, after adjusting possible confounders (OR 1.624, 95% 1.047–2.518, p = 0.030). Interestingly, CAP ≥ 222 dB/m was significantly associated with non-calcified plaque (adjusted OR 3.528, 95% CI 1.463–8.511, p = 0.005), whereas it was not significant in calcified plaques (p = 0.171).


CAP-defined NAFLD is independently associated with coronary plaques, especially non-calcified plaques. The association between NAFLD and non-calcified plaques suggests that particular attention should be given to the subjects with NAFLD for primary prevention.


Coronary plaque Controlled attenuation parameter NAFLD FibroScan 



We thank Boram Park for her contribution to this work, especially with the statistical analysis of the study.

Author contributions

HEP conceived the idea, determined the study design, collected the data, drafted and revised the manuscript. HL collected the data, performed the statistical analysis and revised the manuscript. S-YC collected the data, performed the statistical analysis and revised the manuscript. M-SK determined the study design, collected the data and drafted the manuscript. JIY collected the data and revised the manuscript. JYY collected the data and revised the manuscript. GEC determined the study design, collected the data, performed the statistical analysis and drafted the manuscript. All authors have read and approved the final draft of the manuscript.


There is nothing to declare.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

535_2018_1516_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 16 kb)


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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Division of Cardiology, Department of Internal MedicineHealthcare System Gangnam Center, Seoul National University HospitalSeoulKorea
  2. 2.Division of Gastroenterology, Department of Internal MedicineHealthcare System Gangnam Center, Seoul National University HospitalSeoulKorea

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