Correlation Between Carotid Intima Media Thickness and Non-Alcoholic Fatty Liver Disease

Abstract

Context: Non-alcoholic fatty liver disease (NAFLD) is considered a potential independent risk factor for cardiovascular disease. Increased carotid intima-media thickness (CIMT) is a sign of early atherosclerosis and is linked to an increased risk of myocardial infarction, stroke, and peripheral vascular disease.

Aim: To study correlation between CIMT and NAFLD and its association with increase in grades of NAFLD. Material and Study Design: An observational case control study of 40 cases and 40 controls (age and sex matched) was done. The difference of CIMT between the two groups was analysed. CIMT was also measured among the various grades of NAFLD cases.

Materials and methods: 40 cases with NAFLD and 40 controls falling within the age group of 18-45 years were taken in the study. Patients with history of significant alcohol consumption, acute or chronic liver disease, diabetes mellitus, hypertension, malignancy, hypothyroidism and having dyslipidaemia, CAD and stroke were excluded from the study. All the subjects underwent abdominal and carotid ultrasound in order to assess NAFLD and CIMT measurement. The left and right common carotid artery was examined using PHILIPS HD11XE high-definition ultrasound system equipped with a 3-12 MHz linear array transducer in B mode.

Observation and results: There was a statistically significant difference between the 2 groups in terms of CIMT with a p value of <0.001. The mean CIMT in the Case group was 0.86 mm while in Control group was 0.52 mm. There was a significant difference between the 3 Grades of NAFLD in terms of CIMT with a p value of <0.001 with maximum CIMT being in Grade 3 of NAFLD. Body Mass Index, Alanine Transaminase, Aspartate Transaminase, Alkaline Phosphatase, Total Cholesterol, Triglycerides, Low Density Lipoprotein were also found to have statistical significant difference between cases and controls. Age, gender, Blood pressure, Fasting Blood Sugar, HbA1c, Hemoglobin, Total leucocyte Count, Platelet count, Serum Bilirubin, Total protein and Albumin were found to be statistically insignificantly different between cases and controls.

Conclusion: CIMT is increased in NAFLD patients. Increase in CIMT is significantly correlated with increasing grades of NAFLD. Hence CIMT can be used as screening tests in NALFD patients to assess cardiovascular risks.