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Introduction: Nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) have been explored with coronary angiography which showed a link between severe NAFLD and CVD risk. This study’s aim is to determine if CT coronary artery calcium (CAC) scores used to determine CAD severity in asymptomatic populations can help predict presence of NAFLD.

Methods: Retrospective cross-sectional study of positive CT CAC scores and liver imaging with either CT, ultrasound, or MRI of the abdomen or CT of the chest. Drinking 7 or 14 drinks per week for a woman or man respectively and chronic viral hepatitis diagnosis were excluding criteria. CT CAC scores and hepatic steatosis were correlated by chi-squared analysis. Age, sex, lipid and liver panels, weight, blood pressure, and hemoglobin A1c were correlated to CAD severity and NAFLD by logistic regression.

Results: 134 patients with a median age of 63 years (IQR 57-69), 65% male, BMI 28.5 (IQR 23.9-31.3), and 8% diabetes. CAD severity was not associated with presence of hepatic steatosis (p = 0.36). Multivariate logistic regression showed a link between hepatic steatosis, CAD severity, BMI over 30 (p = 0.02), and diabetes (p = 0.01). There were associations between hepatic steatosis with triglycerides (p = 0.03) and CAD severity with AST (p = 0.02).

Discussion: In patients with CAD detected using a positive CAC CT scan, we determined that BMI over 30 and diabetes were markers of increased NAFLD risk. We determined there was no direct relationship between CAD and hepatic steatosis presence.