The degree of hepatic steatosis associates with impaired cardiac and autonomic function

[Display omitted] •Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat on diastolic autonomic dysfunction. Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver-related morbidity and mortality. The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function, as well as to assess how impairment in cardiac and autonomic function is influenced by metabolic risk factors. Cardiovascular and autonomic function were assessed in 96 sedentary individuals: i) non-alcoholic fatty liver disease (NAFLD) (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), ii) Hepatic steatosis and alcohol (dual aetiology fatty liver disease [DAFLD]) (n = 16, hepatic steatosis >5%, consuming >20 g/day of alcohol) and iii) CONTROL (n = 34, no cardiac, liver or metabolic disorders,