Correlation between coronary calcium score, hepatic steatosis and metabolic syndrome

Objectives. To demonstrate the correlation between the presence or absence of established coronary disease (as measured by the Agatston index) and hepatic steatosis visualized in liver segments when calculating calcium score. Material and Methods. Retrospective study that included 229 patients with risk factors for coronary disease who underwent multislice computed tomography of coronary arteries or calcium score. We evaluated the presence of atherosclerotic disease in coronary arteries and thoracic aorta and liver attenuation in visualized liver segments. Statistical analysis included linear regression models, association studies of multiple variables and CART model. Results. 229 patients, 78% male, average age 56 years. It values statistically significant association was found between higher levels of calcium score and lower hepatic attenuation in older patients and males. We were to define two types of patients with high calcium score, a group with hypertension - hepatic steatosis and another groups with hypertension and type 2 diabetes; patients that were only obese did not have higher levels of calcium score. Conclusions. A relationship exists between calcified atheromatosis disease and hepatics steatosis. Patients with hepatics steatosis as part of a metabolic syndrome are at increased risk of atheroscle- rosis. It may be useful to incorporate the assessment of hepatics steatosis in cardiovascular risk stratification. Keywords: Atheromatosis, Calcium score, Hepatic steatosis, Metabolic syndrome. Resumen: Objetivos. Demostrar la correlacion que existe entre presencia o no de enfermedad coronaria establecida (medida a traves del indice de Agatston) y esteatosis hepatica en los segmentos visualizados del higado al momento de realizar el score de calcio. Material y Metodos. Estudio retrospectivo que incluyo 229 pacientes con factores de riesgo para enfermedad coronaria a los que se les realizo tomografia computada multicorte de arterias coronarias o score de calcio. Se evaluo la presencia de enfermedad ateromatosa en arterias coronarias y aorta toracica y atenuacion hepatica en los segmentos visualizados del higado. El analisis estadistico incluyo modelos de regresion lineal, estudio por asociacion de multiples variables y modelo CART. Resultados. 229 pacientes, 78% de sexo masculino y 22% femenino, con edad promedio 56 anos. Se demostro asociacion estadisticamente significativa entre mayor nivel de score de calcio y menor atenuacion hepatica, en pacientes de mayor edad y sexo masculino. Se logro definir dos tipos de pacientes con score de calcio elevado, un grupo con hipertension arterial - esteatosis hepatica y otro grupo con hipertension arterial y diabetes tipo 2; los pacientes solamente obesos no tenian mayores niveles de score de calcio. Conclusiones. Existe asociacion entre ateromatosis calcificada y esteatosis hepatica. Los pacientes con esteatosis hepatica como parte de un sindrome metabolico, tienen mayor riesgo de ateroesclerosis. Puede ser util incorporar la evaluacion de esteatosis hepatica en la estratificacion de riesgo cardiovascular. Palabras clave: Ateromatosis, Esteatosis, Hepatica, Score de calcio, Sindrome metabolico.