In addition to relationship with a wide spectrum liver disease, non-alcoholic fatty liver disease (NAFLD) has association with non-liver related complications such as cardiovascular disease (CVD) events too. However, there are not consistent results in independent association between NAFLD and CVD events. This study was conducted to determine that if there is an independent association between NAFLD and CVD events.

In the present study, 5147 people whose valid outcome data was available in phase 2 of our cohort study were included. In this phase, the outcomes of patients including the fatal and non-fatal CVD events were obtained based on the report of the closed family of patients and evaluation of medical records. The simple and multiple cox proportional models were conducted to determine the association between NAFLD in primary phase of cohort and the occurrence of fatal and non-fatal CVD events. In multiple models potential mediators such as age and a history of type 2 diabetes mellitus (DM) were considered as potential confounding variables.

Based on our results, the incidence (based on %) of non-fatal CVD events in men with NAFLD was significantly higher than those without NAFLD [4.15% (95% CI =3.21%-5.09%) in men without NAFLD versus 6.56% (95% CI =5.15%-7.96%) in men with NAFLD] with a p-value=0.004. No significant difference was detected in women (between women with NAFLD and without it). While a positive simple association was detected between NAFLD and non-fatal CVD events in men [HR=1.606 (95%CI=1.166-2.212), p-value=0.004] in simple cox proportional hazard model, no independent association was detected between them in multiple cox models. Our results did not show any association between NAFLD and CVD events, fatal or non-fatal, in women according to results of simple and multiple cox proportional hazard models.

No independent association was detected between NAFLD and CVD events. Likely, diabetes mellitus and age can be considered the principle mediators in this regard.