Article Sidebar
Views pdf: 55
SIGNIFICANT LIVER FIBROSIS ASSOCIATED WITH CAROTID ATHEROSCLEROSIS IN PATIENTS WITH TYPE-2 DIABETES MELLITUS
Main Article Content
Abstract
Introduction: Liver fibrosis has been suggested to be associated with carotid atherosclerosis (CA) in patients with type-2 diabetes mellitus (T2DM). However, this relationship has not been fully investigated in Vietnamese population. Objective: To evaluate the association between significant liver fibrosis and both carotid intima-media thickness (cIMT) and carotid atherosclerosis in Vietnamese patients with T2DM. Methods: A prospective, cross-sectional study involving 291 patients with T2DM at Gia Dinh People’s Hospital from July 2023 to July 2024. Hepatic steatosis and fibrosis were assessed using abdominal ultrasonography (GE Logiq V7) and transient elastography by FibroScan. Fatty liver was defined as either sonographic evidence of steatosis or a controlled attenuation parameter (CAP) ≥ 234 dB/m. Significant liver fibrosis (F≥2) was defined as a liver stiffness measurement (LSM) ≥ 7.0 kPa. Carotid plaques and carotid intima-media thickness (cIMT) were evaluated by radiologists using high-resolution ultrasonography equipped with a 12-MHz probe. Multivariate logistic regression analysis was performed to assess the association between significant liver fibrosis and both increased cIMT and the presence of carotid atherosclerosis. Results: Among 291 T2DM patients, the prevalence of CA was 37.8%, and that of elevated cIMT was 26.0%. The proportions of patients with liver fibrosis stages F≥2, F≥3, and F4 were 23.7%, 14.4%, and 8.1%, respectively. Significant liver fibrosis was independently associated with CA (OR: 2.1; p = 0.04) and increased cIMT (OR: 2.3; p = 0.01. In the subgroup analysis of patients with metabolic dysfunction-associated fatty liver disease (MAFLD), significant liver fibrosis remained significantly associated with CA (OR: 2.5; p = 0.02) and increased cIMT (OR: 3.5; p < 0.01). Conclusion: Significant liver fibrosis was associated with increased cIMT and CA in patients with T2DM. This association was also evident in the subgroup of T2DM patients with MAFLD.
Article Details
Keywords
Type-2 diabetes mellitus, metabolic dysfunction-associated fatty liver disease, significant liver fibrosis, carotid atherosclerosis, carotid intima-media thickness.
References
2. ElSayed, N.A., et al., Standards of Care in Diabetes—2023. Diabetes Care, 2023. 46: p. Suppl.1.
3. Lee, H.-H., et al., Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study. Cardiovascular diabetology, 2020. 19: p. 1-11.
4. Arai, T., et al., Liver fibrosis is associated with carotid atherosclerosis in patients with liver biopsy-proven nonalcoholic fatty liver disease. Scientific Reports, 2021. 11(1): p. 15938.
5. Eslam, M., et al., The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease. Hepatology International, 2025: p. 1-41.
6. Lee, H.-H., et al., Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study. Cardiovascular diabetology, 2020. 19(1): p. 1-11.
7. Bessho, R., et al., A significant risk of metabolic dysfunction-associated fatty liver disease plus diabetes on subclinical atherosclerosis. PloS one, 2022. 17(5): p. e0269265.
8. Finney, A.C., et al., The interplay between nonalcoholic fatty liver disease and atherosclerotic cardiovascular disease. Frontiers in Cardiovascular Medicine, 2023. 10: p. 1116861.