title: Nonalcoholic fatty liver disease is associated with subclinical atherosclerosis independent of obesity and metabolic syndrome in Asian Indians.
abstract: OBJECTIVE
  We examined the association of subclinical atherosclerosis and endothelial dysfunction with nonalcoholic fatty liver disease (NAFLD) in Asian Indians.
  
  
  METHODS
  This study included 40 non-diabetic subjects with NAFLD and 40 apparently healthy controls without NAFLD with similar age, gender and body mass index. Measurements included anthropometric parameters, oral glucose tolerance test, fasting and 2 h insulin, lipid profile, C-reactive protein, sICAM-1, VCAM-1, carotid intima-media thickness (CIMT) and brachial artery flow mediated dilatation (FMD).
  
  
  RESULTS
  Subjects with NAFLD had higher average and maximum CIMT (0.6 ± 0.12 and 0.684 ± 0.16 mm, respectively, vs 0.489 ± 0.1 and 0.523 ± 0.1 mm, respectively; p < 0.05), and had higher prevalence of atherosclerotic plaques (20% vs 5%, p < 0.05) than controls. Significantly greater degree of impairment in FMD and higher levels of hs-CRP and sICAM-1 were observed in NAFLD patients than controls. The presence of NAFLD was observed to be the independent predictor of having high average CIMT (OR 4.8; 95% CI: 1.8-12.8), high maximum CIMT (OR 5.4; 95% CI: 2.0-14.4) and impaired FMD (OR 11.7; 95% CI: 1.4-96.5) even after adjusting for obesity, metabolic syndrome, insulin resistance and lipid parameters.
  
  
  CONCLUSIONS
  In Asian Indians NAFLD is significantly associated with subclinical atherosclerosis and endothelial dysfunction independent of obesity and metabolic syndrome. Elevated levels of hs-CRP and sICAM-1 may be useful as indicators of liver injury in NAFLD.
authors: Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Manik Lal
authors: ML
authors: Thakur
authors: Sanjay
authors: S
authors: Sharma
authors: Atin
authors: A
authors: Kumar
authors: Surya Prakash
authors: SP
authors: Bhatt
authors: Kalpana
authors: K
authors: Luthra
authors: Randeep
authors: R
authors: Guleria
authors: Ravindra M
authors: RM
authors: Pandey
authors: Naval K
authors: NK
authors: Vikram
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators