Nonalcoholic Fatty Liver Disease as a Risk Factor for Prolonged Corrected QT Interval in Apparently Healthy Korean Women

Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is clinically important because of its association with an increased risk of sudden cardiac death as well as liver-related mortality. Most cases of sudden cardiac death could be mediated by an arrhythmogenic process. Thus, we aimed to determine the association between NAFLD and corrected QT (QTc) interval in apparently healthy Korean women. Methods: This cross-sectional study included 764 women aged 20 to 74 years old who underwent a health examination program between 2014 and 2015. The QTc interval was calculated using Bazett's formula (QTc = QT/vRR). Multiple linear and logistic regression analysis were performed to assess independent relationships between NAFLD and QTc interval and prolonged QTc (>= 450 milliseconds) was calculated after adjusting for confounding variables. Results: The overall prevalence of NAFLD was 23.5% in general healthy women. The standardized beta coefficient (95% confidence interval) of the QTc increment in patients with NAFLD was 6.4 milliseconds (1.2-11.8) through multiple linear regression analysis after adjusting for age, body mass index, smoking status, and regular exercise as well as mean arterial pressure, fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, calcium, potassium levels and menopause status. Similarly, the odds ratio (95% confidence interval) of NAFLD for prolonged QTc was 2.05 (1.13-3.71) according to multiple logistic regression analysis after adjusting for the same covariables in women aged 20 to 74 years old. Conclusion: We demonstrated the arrhythmogenic potential of NAFLD, implying that careful monitoring of patient electrocardiograms is necessary to evaluate the possible arrhythmic risk in general healthy women with NAFLD.