Background: Non-alcoholic fatty liver disease (NAFLD) is now considered a hepatic component of metabolic syndrome (MS). This condition puts patients with NAFLD at an increased risk of atherosclerosis and cardiovascular disease. This study aimed to assess the prevalence of atherosclerosis and risk of cardiovascular disease in patients with NAFLDand to study its relationship with MS.
Methods: Twenty patients with NAFLD (8 men, mean age 39.90±8.73 years) and 20 age- and gender-matched controls with chronic viral hepatitis (8 men, mean age 39.30±8.21years) were included prospectively in the study. Prevalence of atherosclerosis was studied by measuring the carotid intima-media thickness (CIMT) on carotid ultrasound and by measuring the flowmediated dilatation% (FMD%) on brachial artery doppler ultrasound. The risk of cardiac events at 10 years (RDCE 10) was estimated by the Prospective Cardiovascular Munster study (PROCAM) score.
Results: The mean CIMT of both the right and left side was significantly higher (0.70±0.11 mm vs. 0.61±0.08 mm) (p=0.007) and FMD% was significantly lower in patients with NAFLD (9.79±3.81%) in comparison to controls (17.02±3.39%) (p<0.0001). The mean PROCAM score was higher in patients with NAFLD (27.50±13.32 vs.20.10±7.75) (p=0.067) with the 10-year risk of acute coronary event being 3.9±6.72% in patients with NAFLD in comparison to 1.44±0.85% in controls (p=0.042). On post hoc analysis, a higher CIMT, PROCAM score and 10-year risk of acute coronary events in patients with NAFLD was dependent on MS.
Conclusion: Patients with NAFLD have an increased risk of atherosclerosis and cardiovascular disease.