Article Sidebar
Views PDF: 97
CORRELATION BETWEEN HEPATIC STEATOSIS AND LIVER FIBROSIS WITH CAROTID INTIMA-MEDIA THICKNESS AND CAROTID PLAQUES IN PATIENTS WITH NON-ALCOHOLIC LIVER DISEASE
Main Article Content
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is currently the leading cause of chronic liver disease. Approximately 10 to 30% of patients with NAFLD progress to Nonalcoholic steatohepatitis (NASH). NASH can lead to liver fibrosis, progression to cirrhosis and hepatocellular carcinoma, and eventually death. In addition, NAFLD also increases the risk of cardiovascular diseases such as angina, myocardial infarction and stroke 1.64 times higher than patients without NAFLD. Determining the correlation between NAFLD and carotid intima-media thickness will indirectly contribute to demonstrating the association between NAFLD and cardiovascular risk factors. Objectives: Determine the proportion of NAFLD patients with carotid intima-media thickness (CIMT) ≥ 0.8 mm. Investigation of the correlation between the hepatic steatosis and liver fibrosis by FibroScan - CAP with CIMT in NAFLD patients. Determination of predictive risk factors of CIMT ≥ 0.8 mm in NAFLD patients. Method: Prospective study on 182 NAFLD patients aged 18 years and older who visited Dai Phuoc General Clinic from January 2023 to June 2023. Results: The proportion of NAFLD patients with CIMT ≥ 0.8 mm was 45.1%. The proportion of NAFLD patients with carotid atherosclerosis was 44.0%. There was a positive, strong correlation (r = 0.61) between the hepatic steatosis measured by FibroScan - CAP and CIMT in NAFLD patients. There is a positive, weak correlation (r = 0.37) between liver fibrosis measured by FibroScan and CIMT in NAFLD patients. Age, hypertension, central obesity, and hepatic steatosis were independent risk factors predicting CIMT ≥ 0.8 mm in NAFLD patients. Conclusion: There is a strong positive correlation between the hepatic steatosis measured by FibroScan - CAP and CIMT in NAFLD patients. Carotid doppler ultrasound to measure CIMT, evaluate carotid atherosclerosis should be undergone in NAFLD patients with risk factors such as older age, hypertension, central obesity and hepatic steatosis.
Article Details
Keywords
Nonalcoholic fatty liver disease, carotid intima-media thickness, FibroScan
References
2. Fan J. G., Kim S. U., Wong V. W. New trends on obesity and NAFLD in Asia. J Hepatol. Oct 2017;67(4):862-873. doi:10.1016/j.jhep.2017.06.003
3. Targher G., Byrne C. D., Lonardo A., et al. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. Sep 2016;65(3):589-600. doi:10.1016/j.jhep.2016.05.013
4. Stepanova M., Younossi Z. M. Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population. Clin Gastroenterol Hepatol. Jun 2012;10(6):646-50. doi:10.1016/j.cgh.2011.12.039
5. Villanova N., Moscatiello S., Ramilli S., et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology. Aug 2005;42(2):473-80. doi:10.1002/hep.20781
6. Huang Y., Bi Y., Xu M., et al. Nonalcoholic fatty liver disease is associated with atherosclerosis in middle-aged and elderly Chinese. Arterioscler Thromb Vasc Biol. Sep 2012;32(9):2321-6. doi:10.1161/atvbaha.112.252957
7. Sert A., Aypar E., Pirgon O., et al. Left ventricular function by echocardiography, tissue Doppler imaging, and carotid intima-media thickness in obese adolescents with nonalcoholic fatty liver disease. Am J Cardiol. Aug 1 2013;112(3):436-43. doi:10.1016/j.amjcard.2013.03.056
8. Lorenz M. W., Markus H. S., Bots M. L., et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. Jan 30 2007;115(4):459-67. doi:10.1161/circulationaha.106.628875
9. Wong V. W., Chan W. K., Chitturi S., et al. Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment. J Gastroenterol Hepatol. Jan 2018;33(1):70-85. doi:10.1111/jgh.13857
10. Alberti K. G., Zimmet P., Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. May 2006;23(5):469-80. doi:10.1111/j.1464-5491.2006.01858.x
11. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. Dec 17 2002;106(25):3143-421.
12. Grundy S. M., Cleeman J. I., Daniels S. R., et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. Oct 25 2005;112(17):2735-52. doi:10.1161/circulationaha.105.169404
13. Kwo P. Y., Cohen S. M., Lim J. K. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. Jan 2017;112(1):18-35. doi:10.1038/ajg.2016.517
14. Trần Thị Khánh Tường. Phân tích xét nghiệm sinh hóa gan và các dấu ấn virus viêm gan. Nhà xuất bản Đại Học Huế; 2018.
15. Association American Diabetes. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2017;41(Supplement_1):S13-S27. doi:10.2337/dc18-S002
16. Wong V. W., Vergniol J., Wong G. L., et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. Feb 2010;51(2):454-62. doi:10.1002/hep.23312
17. Karlas T., Petroff D., Garnov N., et al. Non-invasive assessment of hepatic steatosis in patients with NAFLD using controlled attenuation parameter and 1H-MR spectroscopy. PLoS One. 2014;9(3):e91987. doi:10.1371/journal.pone.0091987
18. Ross R., Rissanen J., Hudson R. Sensitivity associated with the identification of visceral adipose tissue levels using waist circumference in men and women: effects of weight loss. Int J Obes Relat Metab Disord. Jun 1996;20(6):533-8.
19. Trần Thị Khánh Tường. Gan nhiễm mỡ. Nhà xuất bản y học, TP. Hồ Chí Minh; 2019.
20. Zheng J., Zhou Y., Zhang K., et al. Association between nonalcoholic fatty liver disease and subclinical atherosclerosis: a cross-sectional study on population over 40 years old. BMC Cardiovasc Disord. Jul 16 2018;18(1):147. doi:10.1186/s12872-018-0877-2
21. Tilg H., Moschen A. R., Roden M. NAFLD and diabetes mellitus. Nat Rev Gastroenterol Hepatol. Jan 2017;14(1):32-42. doi:10.1038/nrgastro.2016.147
22. Tan E. C., Tai M. S., Chan W. K., et al. Association between non-alcoholic fatty liver disease evaluated by transient elastography with extracranial carotid atherosclerosis in a multiethnic Asian community. JGH Open. Apr 2019;3(2):117-125. doi:10.1002/jgh3.12114
23. Shrestha R., Kc S., Thapa P., et al. Estimation of Liver Fat by FibroScan in Patients With Nonalcoholic Fatty Liver Disease. Cureus. Jul 2021;13(7):e16414. doi:10.7759/cureus.16414
24. Takase H., Sugiura T., Murai S., et al. Carotid intima-media thickness is a novel predictor of new onset of hypertension in normotensive subjects. Medicine (Baltimore). Aug 2017;96(31):e7710. doi:10.1097/md.0000000000007710
25. Oni E. T., Agatston A. S., Blaha M. J., et al. A systematic review: burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; should we care? Atherosclerosis. Oct 2013;230(2):258-67. doi:10.1016/j.atherosclerosis.2013.07.052
26. Mohammadzadeh Ali, Shahkarami Vahid, Shakiba Madjid, et al. Association of non-alcoholic fatty liver disease with increased carotid intima-media thickness considering other cardiovascular risk factors. Iranian Journal of Radiology. 2019;16(3)
27. Sinn D. H., Cho S. J., Gwak G. Y., et al. Nonalcoholic Fatty Liver Disease for Identification of Preclinical Carotid Atherosclerosis. Medicine (Baltimore). Jan 2016;95(3):e2578. doi:10.1097/md.0000000000002578
28. Rasool A., Dar W., Latief M., et al. Nonalcoholic fatty liver disease as an independent risk factor for carotid atherosclerosis. Brain Circ. Jan-Mar 2017;3(1):35-40. doi:10.4103/bc.bc_28_16