Association between fatty liver disease and carotid atherosclerosis in patients with uncomplicated type 2 diabetes mellitus (original) (raw)
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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.
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.
2017
Background: Non-alcoholic fatty liver disease (NAFLD) is a common association of Type 2 diabetes mellitus and diabetes mellitus is a leading risk factor for coronary artery disease (CAD). This study aims at estimating the prevalence of NAFLD by ultrasonography and to correlate NAFLD with CAD in a group of patients with Type 2 DM. Methods: Consecutive patients of Type 2 diabetes fulfilling the inclusion criteria were recruited. Clinical and biochemical parameters were recorded. NAFLD was diagnosed by ultrasonography. Results: The prevalence of NAFLD was 41.2% in the study group (n=114) and was higher in females. Prevalence of NAFLD in the younger age group was significantly higher than that in the older age group. Elevated liver enzymes, elevated HbA1C, duration of diabetes, obesity, acanthosis nigricans and metabolic syndrome were all significantly associated with NAFLD. CAD was significantly higher in the NAFLD subgroup (72.46%) compared to the nonNAFLD subgroup (52.63%) (p=0.001)....
Atherosclerosis, 2009
Objective: Controversy exists as to whether the association between nonalcoholic fatty liver disease (NAFLD) and atherosclerosis is independent of other metabolic disorders. We examined the association between NAFLD and carotid intima-media thickness (IMT) according to the presence of metabolic syndrome (MetS). Methods: A cross-sectional analysis was performed among 556 men and 465 women, ages 30-79 years. The presence of NAFLD was evaluated ultrasonographically. Carotid IMT was determined ultrasonographically by the average of the maximal IMT at each common carotid artery. Independent associations between NAFLD and IMT were assessed using multiple linear and logistic regression models, after adjusting for age, sex, waist circumference, systolic blood pressure, fasting glucose, total/HDL-cholesterol ratio, smoking, and alcohol consumption. Results: After adjusting for major risk factors, subjects with NAFLD had greater carotid IMT than subjects without NAFLD (difference 0.034 mm, p = 0.016). However, the difference in IMT was significant only in subjects with MetS (0.060 mm, p = 0.015) and not in subjects without MetS (0.015 mm, p = 0.384). Similarly, the NAFLD-associated adjusted odds ratio for increased IMT, defined as the sex-specific top quintile, was 1.63 (95% CI, 1.10-2.42) in all subjects and 2.08 (95% CI, 1.19-3.66) in subjects with MetS, but 1.18 (95% CI, 0.64-2.19) in subjects without MetS. When the analysis was performed according to the number of metabolic abnormalities, the NAFLD-IMT association was observed only in subjects with four or more abnormalities. Conclusion: These results suggest that NAFLD is independently associated with carotid atherosclerosis only in people who have multiple metabolic abnormalities.
Liver International, 2009
Background/Aims: Diabetic patients have an increased prevalence and severity of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type-2 diabetic individuals.Methods: In a cross-sectional design study, 180 type-2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova, for increasing severity of steatosis) and multivariate logistic regression.Results: The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3–82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [>2.82 mmol/L, odds ratio (OR): 3.7–4.1, 95% CI: 1.2–13.3] and a high-normal ALT level (≥40 U/L, OR: 2.5–2.7, 95% CI: 1.2–5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0–17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9–12.2).Conclusions: Type-2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high-normal ALT levels. Non-alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.
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 ...
2007
ecent data suggest that the presence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes may be linked to increased cardiovascular disease (CVD) independent of components of the metabolic syndrome (1-3), although this hypothesis needs verification in larger studies. We assessed whether NAFLD, as diagnosed by ultrasound, predicts the risk of incident CVD events in a large cohort of type 2 diabetic adults. RESEARCH DESIGN AND METHODS-Study subjects were participants in the Valpolicella Heart Diabetes Study (1). Briefly, we enrolled all of the type 2 diabetic outpatients (n ϭ 2,103) who regularly attended our clinic in the period January-December 2000 after excluding those who had manifest CVD and/or secondary causes of chronic liver disease (alcohol abuse, viral infection, or medications). The local ethics committee approved the study. All participants provided written informed consent. During 6.5 years of follow-up (through December 2006; follow-up range: 5-84 months), 384 participants subsequently developed CVD events (myocardial infarction, ischemic stroke, coronary revascularization, or cardiovascular death), whereas 1,719 patients re