The interplay between abdominal aortic aneurysm, metabolic syndrome and fatty liver disease: a retrospective case-control study.

Background: Abdominal aortic aneurysm (AAA) and fatty liver disease are both associated with the metabolic syndrome (MS); the aim of this study was to investigate whether patients with AAA are also at a higher risk for fatty liver disease.

Methods: A case-control retrospective study. Patients diagnosed with AAA were compared with age- and sex-matched controls regarding the prevalence of fatty liver disease. Extracted data include anthropometric parameters, clinical and laboratory data, and liver imaging.

Results: 995 patients were enrolled in the final analysis, 495 patients with AAA and 500 age- and sex-matched controls. The prevalence of fatty liver disease among AAA subjects was 48.9% compared with 21.2% among the controls (<0.005). After adjusting for age, smoking, body mass index, and MS components, the logistic regression analysis indicates that AAA (men: OR 1.29, 95% CI 1.17, 1.49, =0.001; women: OR 1.23, 95% CI 1.06, 1.43, =0.002), obesity (men: OR 1.32, 95% CI 1.17, 1.59, <0.001; women: OR 1.32, 95% CI 1.07, 1.52, =0.012), hypertension (men: OR 1.23, 95% CI 1.13, 1.46, =0.001; women: OR 1.13, 95% CI 1.00, 1.33, =0.045), MS (men: OR 1.31, 95% CI 1.19, 1.53, =0.001; women: OR 1.28, 95% CI 1.16, 1.42, =0.002) were associated with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH). The prevalence of liver cirrhosis was 1.23%; subjects with obesity, diabetes, hypertension, and AAA had increased risk for cirrhosis (OR 1.89, 95% CI 1.18, 3.22, =0.014; OR 1.27, 95% CI 1.09, 2.72, =0.0027; OR 2.08, 95% CI 1.29, 3.42, =0.004; OR 1.73, 95% CI 1.08, 2.87, =0.027, respectively).

Conclusion: AAA patients are at increased risk for NAFLD/NASH, may predict advance liver disease and liver cirrhosis.