title: Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: a case-control study.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) frequently coexists with obesity, diabetes, and dyslipidemia. We examined whether NAFLD was associated with atherosclerosis, as measured by ultrasound in the carotid arteries.
  
  
  RESULTS
  Carotid atherosclerosis and cardiovascular risk factors were assessed in 40 patients with an ultrasound diagnosis of primary NAFLD and 40 matched population controls. The metabolic syndrome and all its individual traits, including elevated C-reactive protein, were significantly (P<0.005) more frequent in NAFLD patients than in control subjects. Patients with NAFLD showed more carotid atherosclerosis than controls, with mean intima-media thickness (IMT) of 0.70+/-0.20 mm and 0.54+/-0.13 mm (P<0.0001) and plaque prevalence of 50% and 25% (P=0.021), respectively. By multivariate analysis, older age (odds ratio [OR], 2.5 per 10 years; 95% CI, 1.4 to 4.4; P=0.002), the presence of NAFLD (OR, 8.4; 95% CI, 2.49 to 29.4; P=0.001), and elevated serum ferritin (OR, 3.1; 95% CI, 1.2 to 7.9; P=0.016) were independent predictors of an increased IMT.
  
  
  CONCLUSIONS
  Patients with NAFLD show a cluster of risk factors of the metabolic syndrome and advanced carotid atherosclerosis. NAFLD appears to be a feature of the metabolic syndrome, and its detection on abdominal ultrasound should alert to the existence of an increased cardiovascular risk.
authors.affiliation: Lipid Clinic, Internal Medicine Service, Hospital San Millán-San Pedro, Logroño, Spain. a.brea@arrakis.es
authors.forename: Angel
authors.initials: A
authors.lastname: Brea
authors.forename: Daniel
authors.initials: D
authors.lastname: Mosquera
authors.forename: Eva
authors.initials: E
authors.lastname: Martín
authors.forename: Ana
authors.initials: A
authors.lastname: Arizti
authors.forename: José L
authors.initials: JL
authors.lastname: Cordero
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D005234:Fatty Liver / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography