Age, abdominal obesity, and glycated hemoglobin are associated with carotid atherosclerosis in type 2 diabetes patients with nonalcoholic fatty liver disease.
OBJECTIVE
The aim of this study was to evaluate the impact of clinical parameters and indices of body composition on the relation between non-alcoholic fatty liver disease (NAFLD) and carotid intima-media thickness (cIMT), in a type 2 diabetes mellitus population (T2DM).


METHODS
We retrospectively enrolled 336 T2DM outpatients who regularly attended Regina Maria Clinic in Cluj. Clinical, anthropometric and biochemical parameters were measured. Ultrasonography (US) was used to assess hepatic steatosis (HS) in all patients and cIMT in 146 subjects. Body composition was assessed by bioelectric impedance (BIA, InBody 720) in all patients.


RESULTS
cIMT was correlated with age (r=0.25; p=0.004), systolic blood pressure (r=0.18; p=0.041), glycated haemoglobin A1C (HbA1C, r=0.20; p=0.04), and with coronary artery disease (r=0.20; p=0.007). HS did not correlate with cIMT (r=0.04; p=0.64). cIMT was correlated with visceral fatty area (VFA, r=0.18; p=0.014) but not with other indices of body composition. Homeostasis model assessment for insulin resistance (HOMA-IR) was not correlated with cIMT (r=0.17; p=0.086). After multivariate analysis, age, HbA1c, and VFA were good independent predictors of cIMT (r=0.45; p < 0.001).


CONCLUSIONS
These results are suggestive that in T2DM patients, fatty liver is not a direct mediator of early carotid atherosclerosis. Our data indicate that visceral fat accumulation and HbA1C are determinant factors of cIMT sugesting that controlling abdominal obesity and hyperglicemia might reduce atherosclerotic disease risk in NAFLD-T2DM subjects.
Endocrinology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy; County Clinic Emergency Hospital, Cluj-Napoca, Romania.
Cristina Alina
CA
Silaghi
5th Surgery Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. hsilaghi@yahoo.com.
Horațiu
H
Silaghi
Diabet, Nutrition and Metabolic Diseases Department, "Iuliu Hatieganu" University of Medicine and Pharmacy; Regina Maria Clinic, Cluj-Napoca, Romania.
Anca Elena
AE
Crăciun
Regina Maria Clinic, Cluj-Napoca; 1st Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Anca
A
Fărcaș
Medical Informatics and Biostatistics Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Horațiu Alexandru
HA
Colosi
County Clinic Emergency Hospital, Cluj-Napoca; Diabet, Nutrition and Metabolic Diseases Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Daniel Tudor
DT
Cosma
Service Hépatogastroentérologie, Hôpital Pitié- Salpêtrière, Université Pierre et Marie Curie, INSERM UMRS 938, Paris, France.
Raluca
R
Pais
Regina Maria Clinic, Cluj-Napoca, Romania.
Nicolae
N
Hâncu
Endocrinology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Carmen Emanuela
CE
Georgescu
D000367:Age Factors; D001823:Body Composition; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017097:Electric Impedance; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors
D006442:Glycated Hemoglobin