Nonalcoholic fatty liver disease as a predictor of atherosclerosis in obese subjects: a cross-sectional study

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is considered to be the next global epidemic. The prevalence of NAFLD is increasing worldwide paralleling the epidemic of obesity and rise of diabetes mellitus. NAFLD is the leading cause of chronic liver disease, with a prevalence as high as 30% in the general population but cardiovascular diseases are the first cause of death among these subjects. This suggests that the threshold to develop policies of monitoring for cardiovascular disease should be implemented in patients with NAFLD. It has been demonstrated that NAFLD is highly associated with atherosclerosis. It appears that NAFLD may induce insulin resistance, oxidative stress, inflammation, dyslipidemia and fluctuation of adipokines associated with atherosclerosis. OBJECTIVE: This study aim to evaluate the possible influence of NAFLD on markers of subclinical atherosclerosis (c-IMT and/or plaques). METHODS: We studied 400 consecutive obese subjects (282 women; mean age, 45,6± 9,33; BMI 43,87 ± 6,22 and 118 men; mean age 43,89 ± 9,28; BMI 43,87 ± 6,22). Hepatic steatosis and atherosclerosis [carotid intima-media thickness (cIMT) >0.8 mm and/or presence of plaques] were evaluated ultrasonographically. RESULTS: NAFLD and age were the best predictors of atherosclerosis using c-IMT, in both obese men and women. NAFLD in obese women could predict not only c-IMT but also the presence of atheroma plaques. CONCLUSIONS: Non-alcoholic fatty liver disease and age could be predictors for carotid atherosclerosis in obese subject