It’s known that abdominal fat raises the risk of heart disease, diabetes, and kidney disease. While we used to think of abdominal fat as chemically inactive, we’ve since learned that those fat cells produce hormones and other toxic chemicals that can damage nearby organs.

We’re also learning that excess fat in the liver sets up the same dynamic; these fat cells also manufacture toxic substances that can elevate your risk of heart disease. The fat cells are so toxic that they can increase your risk for heart disease even in the absence of other factors.

In fact, this is such a strong association that the American Heart Association issued its first ever scientific statement on the link between nonalcoholic fatty liver disease (NAFLD) and heart disease to raise awareness among doctors.

But NAFLD doesn’t need to be severe to affect your heart. Researchers at Cedars-Sinai Medical Center found that even mild forms can damage heart health. They looked at a marker for liver fibrosis (stiffening of the liver) and found that even mild fibrosis can lead to abnormalities in heart function and the size of the coronary vessels, according to their study published in the journal Frontiers in Cardiovascular Medicine.