[Nonalcoholic fatty liver disease as a risk factor of cardiovascular disease: relation of non-alcoholic fatty liver disease to carotid atherosclerosis].
OBJECTIVE
Non-alcoholic fatty liver disease (NAFLD) is closely associated with abdominal obesity, dyslipidemia, hypertension, and Type 2 diabetes, which are all features of the metabolic syndrome. The aim of the present study was to elucidate whether NAFLD is associated with carotid atherosclerosis.


METHODS
The study population comprised 659 subjects without hepatitis B and C infections and who did not consume alcohol. Fatty infiltrations of liver were detected by abdominal ultrasonography, and intima-media thickness (IMT) and plaque prevalence were estimated by carotid ultrasonography.


RESULTS
The mean values of systolic and diastolic pressures, body mass index (BMI), aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, uric acid, total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, fasting glucose, fasting insulin, homeostasis model of assessment (HOMA) index, hemoglobin A1c, and plasminogen activator inhibitor-1 differed significantly between patients with NAFLD (n=314) and normal controls (n=345). The carotid IMT was 0.817+/-0.212 (mean+/-SD) mm in patients with NAFLD and 0.757+/-0.198 mm in normal controls (p<0.001). The prevalence of carotid plaques was higher in patients with NAFLD (26.4%) than in normal controls (15.9%) (p<0.001). This association persisted significantly after adjusting for age, sex, BMI, HOMA index and individual factors of metabolic syndrome by multiple logistic regression analysis.


CONCLUSIONS
Patients with NAFLD are at a high risk of carotid atherosclerosis regardless of metabolic syndrome and classical cardiovascular risk factors. Therefore, the detection of NAFLD should alert to the existence of an increased cardiovascular risk. Moreover, NAFLD might be an independent risk factor for cardiovascular disease.
Choi
Su-Yeon
SY
Seoul National University Hospital Healthcare System Gangnam Center, Healthcare Research Institute, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kim
Donghee
D
Kang
Jin Hwa
JH
Park
Min Jung
MJ
Kim
Young Sun
YS
Lim
Seon Hee
SH
Kim
Chung Hyeon
CH
Lee
Hyo-Suk
HS
D000368:Aged; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis; D003927:Diet, Diabetic; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D012044:Regression Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
D008076:Cholesterol, HDL; D014280:Triglycerides