title: Non-alcoholic fatty liver disease fibrosis score and preclinical vascular damage in morbidly obese patients.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is strongly related with enhanced morbidity and mortality from cardiovascular disease. In obese patients with both NAFLD and features of the metabolic syndrome, the cardiovascular risk is further increased.
  
  
  OBJECTIVE
  The aim of this study is to investigate the relationship between severity of liver fibrosis evaluated by NAFLD fibrosis score (NAFLD-FS), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), other obesity-related markers and preclinical atherosclerosis in morbidly obese patients with previously diagnosed NAFLD.
  
  
  METHODS
  Laboratory parameters, visceral fat area (VFA), flow-mediated dilatation (FMD), intima-media thickness (IMT), HOMA-IR and NAFLD-FS were determined in 196 morbidly obese patients.
  
  
  RESULTS
  Patients with higher NAFLD-FS or HOMA-IR show higher left max-IMT and lower FMD (p<0.001). VFA and NAFLD-FS, but not HOMA-IR, were independent predictors of reduced FMD (respectively β -0.268, p=0.001 and β -0.165, p=0.039, p of the model<0.001) and increased left max-IMT (respectively β 0.165, p=0.031 and β 0.301, p<0.001, p of the model<0.001).
  
  
  CONCLUSIONS
  In morbidly obese patients, NAFLD-FS correlates with markers of early vascular damage. NAFLD-FS, easier to obtain than VFA, seems to be a better score than HOMA-IR to categorize such subjects who are potentially at risk of future cardiovascular events.
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy. Electronic address: alessandra.gentili1987@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gentili
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Daviddi
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Vuono
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Maria Anastasia
authors.initials: MA
authors.lastname: Ricci
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Filippo
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Abdalkader
authors.initials: A
authors.lastname: Alaeddin
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Massimo R
authors.initials: MR
authors.lastname: Mannarino
authors.affiliation: Department of Surgery, "San Giovanni Battista" Hospital, Foligno (Perugia), Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Boni
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vaudo
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy.
authors.forename: Graziana
authors.initials: G
authors.lastname: Lupattelli
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D005260:Female; D005355:Fibrosis; D006801:Humans; D007333:Insulin Resistance; D007558:Italy; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging*; D009767:Obesity, Morbid / Q000150:complications*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: Cardiovascular disease; Morbid obesity; Preclinical atherosclerosis