Nonalcoholic fatty liver disease as an independent risk factor for carotid atherosclerosis

PURPOSE: Nonalcoholic fatty liver disease (NAFLD) is a frequently encountered clinical condition in clinical practice, particularly in obese and diabetic patients. Carotid atherosclerosis is regarded as surrogate marker of coronary atherosclerosis. We aimed to know whether evaluation for carotid atherosclerosis should be done in all patients of NAFLD. MATERIALS AND METHODS: A total of 200 NAFLD patients and 100 age- and sex-matched controls were enrolled into the study. Ultrasound was done to document fatty liver and carotid intimal thickness, and relation between these two was observed. RESULTS: Grade 1 fatty liver was seen in 36% patients while Grade 2 fatty liver was found in 39% and Grade 3 fatty liver in 25%. Patients with Grade 1 fatty liver had left intima-media thickness (IMT) in the range of 0.4–0.6 mm (mean IMT - 0.69 mm) and had right IMT in the range of 0.5–0.8 mm (mean IMT - 0.71 mm). In patients with Grade 2 fatty liver, left IMT was in the range of 0.6–1.0 mm (mean IMT - 0.80 mm) and right IMT in the range of 0.7–1.0 mm (mean IMT - 0.84 mm), while in patients with Grade 3 fatty liver, left IMT was in the range of 0.8–1.2 mm (mean IMT - 0.93 mm) and right IMT in the range of 0.9–1.4 mm (mean IMT - 0.99 mm). Among controls, the mean left IMT was 0.579 mm and mean right IMT was 0.575 mm. CONCLUSION: The level of carotid intimomedial thickness was more in cases than in controls and progressively increased with the grade of fatty liver which was statistically significant.