Atherosclerosis and Associated Cardiovascular Risk Factors in Nonalcoholic Fatty Liver Disease and Metabolic Syndrome

ABSTRACT

Objectives: Nonalcoholic fatty liver disease (NAFLD) is a well-known contributor for the development of cardiovascular disease (CVD). Nonalcoholic fatty liver disease is considered as the liver component of metabolic syndrome (MetS). This study aimed to assess the influence of NAFLD and MetS on markers of subclinical atherosclerosis, including carotid intima-media thickness (CIMT), ankle-brachial pressure index (ABI), and to investigate the impact of NAFLD and MetS on left ventricular (LV) diastolic and systolic function. Study design: A case-control study. Materials and methods: In this case-control study, 120 cases and 90 healthy controls in the age group ranging from ?18 to ?65 years were included. Metabolic syndrome was assessed using International Diabetes Federation (IDF) criteria. Height, weight, waist circumference, body mass index (BMI), and blood pressure were measured. Liver ultrasonographic scanning was used for assessing fatty liver. To assess atherosclerosis, CIMT and ABI were used. Results: The prevalence of NAFLD was 66.7%. As compared with control subjects, patients with NAFLD had a significantly greater (p = 0.02) mean CIMT while in patients with MetS, it was not significant. Left ventricular diastolic and systolic function were significantly impaired (p = 0.03, p = 0.04, respectively) in NAFLD while only LV diastolic function was significantly (p = 0.04) impaired in MetS. There was a strong positive correlation between CIMT and triglyceride (TG) (r = 0.46, p = 0.0001), total cholesterol (TC) (r = 0.47, p = 0.0001), low density lipoprotein cholesterol (LDL-C) (r = 0.46, p = 0.0001), very low density lipoprotein cholesterol (VLDL-C) (r = 0.259, p = 0.001), BMI (r = 0.21, p = 0.003), and age (r = 0.22, p = 0.002). Conclusions: Carotid intima-media thickness, ABI, and LV diastolic function were affected in patients with NAFLD and MetS.