Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Association of NAFLD Fibrosis Score (NFS) with Coronary Artery Disease (CAD) in Patients with NAFLD

Document Type : Original Article

Author
Armin Attar
Student Research Committee, Iran University of Medical sciences, Tehran , Iran
10.22118/jsmj.2025.517376.3875
Abstract
Background and Objectives  Non-alcoholic fatty liver disease (NAFLD) has been linked to coronary artery disease (CAD), yet the clinical utility of non-invasive fibrosis indices for identifying CAD in NAFLD remains uncertain. This study examined whether the NAFLD Fibrosis Score (NFS) is associated with the presence of CAD in a higher-risk NAFLD cohort.
Subjects and Methods This cross-sectional study was conducted using medical records of patients with ultrasound-diagnosed NAFLD. To focus on a higher-risk population and reduce heterogeneity, an analytic cohort was restricted to individuals aged ≥45 years with moderate-to-severe fatty liver (grade ≥2) and at least one cardiometabolic risk factor (hypertension, dyslipidemia, or impaired fasting glucose [100–125 mg/dL]). CAD status was defined based on documented coronary or ischemic heart disease in the medical file. NFS was calculated using the standard formula. ROC analysis was performed to evaluate discrimination, and multivariable logistic regression was used to identify factors independently associated with CAD.
Results A total of 32 patients were included (CAD-positive: 15; CAD-negative: 17). Patients with CAD were older than those without CAD (59.0 vs. 52.2 years, p=0.023). Mean NFS did not differ significantly between groups (p=0.544). The discriminatory performance of NFS for CAD was modest (AUC=0.584). The optimal NFS cut-off was −1.451 (sensitivity 80.0%, specificity 41.2%). In multivariable analysis (excluding hypertension due to complete separation), age remained independently associated with CAD (OR=1.253; 95% CI: 1.035–1.516; p=0.020), while NFS category was not independently associated.
Conclusion In a restricted higher-risk NAFLD cohort, NFS showed limited ability to discriminate CAD and was not an independent predictor after adjustment. Age remained a key factor associated with CAD. Larger studies with coronary-specific definitions are warranted.
Keywords
NAFLD Fibrosis Score
coronary artery disease
risk factors
Subjects
 
 
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  • Receive Date 21 April 2025
  • Revise Date 15 May 2025
  • Accept Date 29 June 2025