title: Liver fat content is negatively associated with atherosclerotic carotid plaque in type 2 diabetic patients.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is independently associated with atherosclerosis in nondiabetic individuals. In type 2 diabetic patients, the link between fatty liver and atherosclerosis is less clear. Here, we assessed whether liver fat content evaluated using (1)H-magnetic resonance spectroscopy ((1)H-MRS) was independently associated with prevalent carotid plaque as a marker of atherosclerosis in type 2 diabetic patients.
  
  
  METHODS
  One hundred and forty-four prospectively enrolled patients with type 2 diabetes underwent liver fat content measurement using (1)H-MRS and carotid plaque assessment using ultrasound. Multiple logistic regressions were used to identify factors associated with carotid plaque.
  
  
  RESULTS
  Mean ± SD liver fat content was 9.86±8.12%. Carotid plaque prevalence was 52.1% (75/144). Patients without plaque were younger (P=0.006) and had a smaller visceral fat area (P=0.015), lower reported prevalence of previous cardiovascular events or current statin therapy (P=0.002), and higher liver fat content than those with plaque (P=0.009). By multivariable logistic regression, increased liver fat content independently predicted the absence of carotid plaque [odds ratios (ORs), 0.94; 95% confidence intervals (CIs), 0.89-0.99; P=0.017].
  
  
  CONCLUSIONS
  Liver fat content measured by (1)H-MRS is higher in type 2 diabetic patients without carotid plaque compared to those with plaque. This study suggests that increased liver fat content could be associated with a relative protection against carotid atherosclerosis in patients with type 2 diabetes mellitus.
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Romaric
authors.initials: R
authors.lastname: Loffroy
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Terriat
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Jooste
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Robin
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Brindisi
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hillon
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vergès
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Cercueil
authors.affiliation: 1 Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 2 LE2I, UMR CNRS 6306, University of Burgundy, Dijon, France ; 3 Department of Angiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France ; 4 Inserm U866, University of Burgundy, Dijon, France ; 5 Department of Endocrinology, Diabetes and Nutrition, 6 Department of Hepatology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Petit
keywords: Hepatic steatosis; atherosclerosis; carotid plaque; nonalcoholic fatty liver disease (NAFLD); type 2 diabetes