Purpose: To evaluate, in patients with nonalcoholic fatty liver disease with no or mild alterations of liver function tests, carotid artery intima-media thickness and the presence of plaques and to define determinants of vascular damage. Methods: A paired-sample case-control study: 125 patients with nonalcoholic fatty liver disease and 250 controls, without a prior diagnosis of diabetes, hypertension, and cardiovascular disease, matched for sex, age, and body mass index. B-mode ultrasound was used for evaluation of carotid intima-media thickness and presence of small plaques. Results: A significant difference in mean values of intima-media thickness (0.89 ± 0.26 and 0.64 ± 0.14 mm, P = .0001) and prevalence of plaques (26 [21%] and 15 [6%], P <.001) was observed in nonalcoholic fatty liver disease patients and controls. Variables significantly associated with intima-media thickness higher than 0.64 mm (median value in controls), in both patients and controls were: age (P = .0001), systolic blood pressure (P = .004), total and low-density lipoprotein cholesterol (P ≤.02 and P = .01, respectively), fasting glucose (P = .0001), and cardiovascular risk (P = .0001) and, only in controls, metabolic syndrome (P = .0001), HOMA-insulin resistance (P = .01), and body mass index (P = .0003). At multivariate logistic regression performed in the overall series of subjects, independent risk predictors of intima-media thickness higher than 0.64 mm were presence of steatosis (odds ratio [OR] = 6.9), age (OR 6.0), and systolic blood pressure (OR 2.3). Conclusion: Patients with nonalcoholic fatty liver disease, even with no or mild alterations of liver tests, should be considered at high risk for cardiovascular complications.
Carotid artery intima-media thickness in nonalcoholic fatty liver disease / A.L. Fracanzani, L. Burdick, S.L. Raselli, P.S. Pedotti, L. Grigore, G. Santorelli, L.V.C. Valenti, A. Maraschi, A.L. Catapano, S.R. Fargion. - In: THE AMERICAN JOURNAL OF MEDICINE. - ISSN 0002-9343. - 121:1(2008), pp. 72-78.
Carotid artery intima-media thickness in nonalcoholic fatty liver disease
A.L. FracanzaniPrimo
;S.L. Raselli;P.S. Pedotti;G. Santorelli;L.V.C. Valenti;A. Maraschi;A.L. CatapanoPenultimo
;S.R. FargionUltimo
2008
Abstract
Purpose: To evaluate, in patients with nonalcoholic fatty liver disease with no or mild alterations of liver function tests, carotid artery intima-media thickness and the presence of plaques and to define determinants of vascular damage. Methods: A paired-sample case-control study: 125 patients with nonalcoholic fatty liver disease and 250 controls, without a prior diagnosis of diabetes, hypertension, and cardiovascular disease, matched for sex, age, and body mass index. B-mode ultrasound was used for evaluation of carotid intima-media thickness and presence of small plaques. Results: A significant difference in mean values of intima-media thickness (0.89 ± 0.26 and 0.64 ± 0.14 mm, P = .0001) and prevalence of plaques (26 [21%] and 15 [6%], P <.001) was observed in nonalcoholic fatty liver disease patients and controls. Variables significantly associated with intima-media thickness higher than 0.64 mm (median value in controls), in both patients and controls were: age (P = .0001), systolic blood pressure (P = .004), total and low-density lipoprotein cholesterol (P ≤.02 and P = .01, respectively), fasting glucose (P = .0001), and cardiovascular risk (P = .0001) and, only in controls, metabolic syndrome (P = .0001), HOMA-insulin resistance (P = .01), and body mass index (P = .0003). At multivariate logistic regression performed in the overall series of subjects, independent risk predictors of intima-media thickness higher than 0.64 mm were presence of steatosis (odds ratio [OR] = 6.9), age (OR 6.0), and systolic blood pressure (OR 2.3). Conclusion: Patients with nonalcoholic fatty liver disease, even with no or mild alterations of liver tests, should be considered at high risk for cardiovascular complications.Pubblicazioni consigliate
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