Nonalcoholic fatty liver is not associated with carotid intima-media thickness in type 2 diabetic patients

J Clin Endocrinol Metab. 2009 Oct;94(10):4103-6. doi: 10.1210/jc.2009-0541. Epub 2009 Jul 7.


Objective: Nonalcoholic fatty liver disease (NAFLD) is commonly associated with obesity, metabolic syndrome, and type 2 diabetes. Several studies suggest that NAFLD is independently associated with an increased risk of cardiovascular disease in nondiabetic subjects. In type 2 diabetic subjects, the link between fatty liver and atherosclerosis is less clear. In this study, we set out to determine, whether fatty liver content, evaluated using 1H-magnetic resonance spectroscopy, a very precise imaging technique, was associated with atherosclerosis in people with type 2 diabetes.

Research design and methods: A total of 101 patients with type 2 diabetes mellitus were included in this study. Liver fat (1H-magnetic resonance spectroscopy) and carotid intima media thickness (IMT) were measured.

Results: Sixty-one (60.3%) patients had steatosis (hepatic triglyceride content greater than 5.5%). Liver fat content was correlated with fasting serum triglycerides (r = 0.22; P = 0.02) and alanine aminotransferase (r = 0.42; P = 0.0001). Sixty-eight percent of subjects with severe steatosis (hepatic triglyceride content greater than 15%) had aspartate aminotransferase in the normal range. Age was strongly correlated with IMT (r = 0.37; P = 0.0002). Steatosis did not correlate with IMT (r = -0.03; P = 0.75). There was no significant difference between the two groups (with and without hepatic steatosis) for IMT values.

Conclusions: this study suggests that in people with type 2 diabetes, fatty liver is not associated with cardiovascular disease. In a diabetic population, it seems that fatty liver is not a determinant factor associated with carotid IMT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alanine Transaminase / blood
  • Atherosclerosis / complications
  • Atherosclerosis / pathology*
  • Biomarkers / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / pathology*
  • Fatty Liver / complications
  • Fatty Liver / metabolism
  • Fatty Liver / pathology*
  • Female
  • Humans
  • Liver / metabolism
  • Liver / pathology
  • Magnetic Resonance Spectroscopy* / methods
  • Male
  • Middle Aged
  • Prospective Studies
  • Protons
  • Triglycerides / blood
  • Tunica Intima / pathology*
  • Tunica Media / pathology*


  • Biomarkers
  • Protons
  • Triglycerides
  • Alanine Transaminase