Carotid lesions in outpatients with nonalcoholic fatty liver disease (original) (raw)
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A Study of Carotid Atherosclerosis in Patients with Non-alcoholic Fatty Liver Disease
Indian Journal of Clinical Biochemistry, 2012
Non-alcoholic fatty liver disease shares many features of metabolic syndrome and its presence could signify a substantial cardiovascular risk above and beyond that conferred by individual risk factors. This study is an attempt to investigate the association of non-alcoholic fatty liver disease with carotid intima-media thickness and plaque as surrogate measures of increased cardiovascular risk. The study was conducted on 645 non diabetic, non alcoholic subjects in the age range of 20-60 years. Metabolic syndrome was assessed by using ATP III and ADA (2005) criteria. Anthropometric factors-waist circumference and blood pressure were measured. Fasting serum samples were analyzed for glucose, triglyceride, cholesterol and its fractions, insulin, alanine and aspartate transaminases, gamma glutamyl transferase and free fatty acids. Insulin resistance and secretion were calculated by homeostasis model and insulin sensitivity by QUICKI index. Liver ultrasonographic scanning was used for assessing fatty liver. Carotid atherosclerosis was assessed by B-mode ultrasonography of common carotid artery and internal carotid artery. The prevalence of non-alcoholic fatty liver disease was 15.6 % in non alcoholic population and 68.5 % of non-alcoholic fatty liver disease had metabolic syndrome, which was associated with hyperinsulinemia, insulin resistance, insulin insensitivity along with elevated levels of waist circumference, blood pressure, triglyceride, FFA and decreased HDL cholesterol. NAFLD patients had markedly greater carotid intima media thickness than non NAFLD subjects with MCIMT of 591.6 ± 108 and 489.5 ± 132.4 lm (P \ 0.001) and plaque prevalence of 19.2 and 2.2 %, respectively, thus the carotid intima media thickness is associated with NAFLD.
Diabetes Care, 2006
OBJECTIVE—Nonalcoholic fatty liver disease (NAFLD) is closely associated with several metabolic syndrome features. We assessed whether NAFLD is associated with carotid artery intima-media thickness (IMT) as a marker of subclinical atherosclerosis and whether such an association is independent of classical risk factors, insulin resistance, and metabolic syndrome features. RESEARCH DESIGN AND METHODS—We compared carotid IMT, as assessed by ultrasonography, in 85 consecutive patients with biopsy-proven NAFLD and 160 age-, sex-, and BMI-matched healthy control subjects. RESULTS—NAFLD patients had a markedly greater carotid IMT (1.14 ± 0.20 vs. 0.82 ± 0.12 mm; P < 0.001) than control subjects. The metabolic syndrome (according to Adult Treatment Panel III criteria) and its individual components were more frequent in those with NAFLD (P < 0.001). The marked differences in carotid IMT observed between the groups were only slightly weakened after adjustment for age, sex, BMI, smoking ...
Nonalcoholic Fatty Liver Disease for Identification of Preclinical Carotid Atherosclerosis
Medicine, 2016
Nonalcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease, yet whether identification of NAFLD in asymptomatic individuals is helpful over established risk factors remains unknown. A total of 37,799 asymptomatic adults aged 20 years or older who underwent comprehensive health checkup examination, including abdominal and carotid artery duplex ultrasonography (US) were included in the analysis. Nonalcoholic fatty liver disease was diagnosed with US and exclusion of secondary causes of fat accumulation or other causes of chronic liver disease, and graded as mild or moderate to severe fatty liver. Individuals with carotid plaque identified on carotid artery US were considered at risk for cardiovascular disease. Metabolic syndrome (MetS) was defined by the adult treatment panel III criteria. Nonalcoholic fatty liver disease was an independent factor associated with carotid plaque in a dose-dependent manner (odds ratio [OR]; 95% confidence interval [
Objective: To determine the association between nonalcoholic fatty liver disease (NAFLD) and raised carotid intima-media thickness Materials & Methods: This cross-sectional study was conducted at Department of Medicine, Bahawal Victoria Hospital, Bahawalpur from July 2019 to December 2019 over the period of 6 months. Total 109 patients either male or female having age from 30-45 years having nonalcoholic fatty liver disease were selected for this study. Results: The mean age in cases group was 37.51 ± 4.07 years and in control group was 37.45 ± 4.03 years. Out of 218 patients, 136 (62.39%) were males and 82 (37.61%) were females with male to female ratio of 1.7:1. Frequency of raised CIMT in cases group was seen in 62 (56.88%) while in control group was seen in 41 (37.61%) cases with a p-value of 0.004 and odds ratio of 2.1879 which is statistically significant and shows a positive association between NAFLD and raised CIMT. Conclusion: This study concluded that the frequency of raised carotid intima-media thickness is higher in patients with non-alcoholic fatty liver disease and shows the positive association between nonalcoholic fatty liver disease (NAFLD) and raised carotid intima-media thickness.
Carotid Artery Intima-Media Thickness and Nonalcoholic Fatty Liver Disease Severity
Journal of Cardiovascular Diseases & Diagnosis, 2014
Mortality associated with NAFLD, 10-15 years after its diagnosis, is about 10-12%, and is significantly higher in patients with the more advanced stages of this condition. In this same period of time, the risk of progression to cirrhosis is 5-10%, and 1-2% to hepatocellular carcinoma [2]. Increasing number of studies have shown that the higher mortality rate among NAFLD patients in comparison to the general population is chiefly due to concomitant cardiovascular disease (CVD) than does the progression of the liver disorder [3-6]. The strong association between NAFLD and MS may explain the high cardiovascular mortality observed in NAFLD patients [7]. Furthermore, accumulating evidence suggests that NAFLD is by itself a risk factor for coronary artery disease independently of established risk factors [8-11].
Is treatment of fatty liver effective on reducing carotid intima media thickness; a cohort study
Aim: This study was intended to explore the effect of various drugs used to treat fatty liver on intimal-media thickness in patients with NAFLD. Background: Nonalcoholic fatty liver disease (NAFLD) is an indicator of a broad spectrum of pathologic disorders, which is characterized with macro vesicular steatosis in the absent of alcohol use. It has a wide range of laboratory, clinical and pathological presentations such as simple steatosis to the diseases like non-alcoholic steatohepatitis, fibrosis, and cirrhosis and hepatocellular cancer. Methods: In this cross-sectional study, as a part of a 10-year cohort study (from 2007-2017) at Tabriz University of Medical Sciences, a group of 100 patients with NAFLD were studied. They were examined by color doppler sonography of the carotid arteries to detect any carotid intima-media thickness, before and one year after treatment with various drugs. The effect of treatment on right and left carotid intima-media thickness (IMT) was examined by using SPSS. V21. Results: Over all, 36 (36%) patients were male and 64 (64%) were female. The mean age of the patients was a 43.5±10.3 year, ranging from 16 to 64. The decrease in patients' intima-media thickness in both right and left carotids was statistically significant (P<0.0001). Conclusion: Treatment of patients with nonalcoholic fatty liver has a significant role in reduction of their carotid intima-media thickness and consequently in reducing cerebrovascular events such as stroke.
Digestive Diseases and Sciences, 2008
Aim The aim of this study was to evaluate metabolic syndrome (MetS) frequency and carotid artery intima-media thickness (IMT) as risk factors for atherosclerosis in patients with nonalcoholic fatty liver disease. Methods A case-control study was conducted on 40 biopsy-proven NAFLD patients and 40 age-matched healthy control subjects. Common carotid artery IMT and MetS criteria [according to the Third Report of the National Cholesterol Education Expert Panel on Detection, evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII), the International Diabetes Federation (IDF), the American Heart Association in conjunction with the National Heart, Lung, and Blood Institute (AHA/NHLBI)] were evaluated for all study subjects. Results MetS according to NCEP-ATPIII, IDF and AHA/NHLBI criteria was present in 55, 67.5 and 62.5% of NAFLD patients, respectively. The mean IMT was significantly higher in NAFLD patients (0.646 ± 0.091 mm) than control subjects (0.544 ± 0.067 mm), (P < 0.001). Among the vascular risk factors evaluated, the diagnosis of NAFLD and increased body mass index were significant independent predictors of increased IMT. Conclusions As cardiovascular risk factors, both MetS and increased IMT occur frequently among NAFLD patients. Screening for both conditions might be beneficial for assessment of future atherosclerotic complications.