ArticlePloS one2017
Nonalcoholic fatty liver disease is associated with an increased risk of heart block in hospitalized patients with type 2 diabetes mellitus.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Relationship between non-alcoholic fatty liver disease and cardiac arrhythmia: a systematic review and meta-analysis.The Journal of international medical research · 2021Pooled it
- Association Between Left Ventricular Global Longitudinal Strain and Hepatic Inflammation and Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.Diagnostics (Basel, Switzerland) · 2025Article
- Guideline-directed medical strategies for the co-management of heart failure and metabolic dysfunction-associated steatotic liver disease.Communications medicine · 2025Review
- Cardiometabolic Dysregulation and Heart Failure.Reviews in cardiovascular medicine · 2025Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease: Pathogenetic Links to Cardiovascular Risk.Biomolecules · 2025Review
- Additive effect of metabolic dysfunction-associated fatty liver disease on left ventricular function and global strain in type 2 diabetes mellitus patients: a 3.0 T cardiac magnetic resonance feature tracking study.Cardiovascular diabetology · 2024Article
- Article
- Nonalcoholic Fatty Liver Disease as a Potential Risk Factor for Cardiovascular Disease in Patients with Type 2 Diabetes: A Prospective Cohort Study.International journal of endocrinology · 2024Article
- Incident cardiac arrhythmias associated with metabolic dysfunction-associated steatotic liver disease: a nationwide histology cohort study.Cardiovascular diabetology · 2023Article
- How non-alcoholic fatty liver disease and cirrhosis affect the heart.Hepatology international · 2023Review
- New Insights into the Pathogenesis of Metabolic-Associated Fatty Liver Disease (MAFLD): Gut-Liver-Heart Crosstalk.Nutrients · 2023Review
- Retinal Vascular Lesions in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2023Review
- Non-Alcoholic Fatty Liver Disease and Risk of Macro- and Microvascular Complications in Patients with Type 2 Diabetes.Journal of clinical medicine · 2022Review
- "Bioelectrical impedance analysis in managing sarcopenic obesity in NAFLD".Obesity science & practice · 2021Review
- Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management.Diagnostics (Basel, Switzerland) · 2021Review
- Review
- Cardiovascular Disease in Nonalcoholic Steatohepatitis: Screening and Management.Current hepatology reports · 2020Article
- A preliminary report about the detection of ventricular repolarisation in patients with non-alcoholic fatty liver disease.Journal of Taibah University Medical Sciences · 2020Article
- The risk of atrial fibrillation in patients with non-alcoholic fatty liver disease and a high hepatic fibrosis index.Scientific reports · 2020Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent studies suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiac tachyarrhythmias (mainly atrial fibrillation) in patients with and without type 2 diabetes mellitus. The aim of this study was to examine whether an association also exists between NAFLD and heart block. We have retrospectively evaluated a hospital-based cohort of 751 patients with type 2 diabetes discharged from our Division of Diabetes and Endocrinology during years 2007-2014. Standard electrocardiograms were performed on all patients. Diagnosis of NAFLD was based on ultrasonography, whereas the severity of advanced hepatic fibrosis was based on the fibrosis (FIB)-4 score and other non-invasive fibrosis markers. Overall, 524 (69.8%) patients had NAFLD and 202 (26.9%) had heart block (defined as at least one block among first-degree atrio-ventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block) on electrocardiograms. Patients with NAFLD had a remarkably higher prevalence of any persistent heart block than those without NAFLD (31.3% vs. 16.7%, p<0.001); this prevalence was particularly increased among those with higher FIB-4 score. NAFLD was associated with a threefold increased risk of prevalent heart block (adjusted-odds ratio 3.04, 95% CI 1.81-5.10), independently of age, sex, hypertension, prior ischemic heart disease, hemoglobin A1c, microvascular complication status, use of medications and other potentially confounding factors. In conclusion, this is the largest cross-sectional study to show that NAFLD and its severity are independently associated with an increased risk of prevalent heart block in hospitalized patients with type 2 diabetes.
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