A Study of Correlation between Non Alcoholic Fatty Liver Disease and Carotid Atherosclerosis

Non-Alcoholic Fatty Liver Disease (NAFLD) is a clinicopathological condition characterized by a wide spectrum of histological abnormalities and clinical outcome. The underlying histological abnormality is hepatic steatosis, characterized by fatty infiltration of liver cells resembling that of alcohol-induced liver injury but occurring in patients who do not abuse alcohol. NAFLD is now recognised as one of the most common form of chronic liver diseases in developed countries with an estimated prevalence of 12-24% in the Asian population. Patients with NAFLD show a cluster of abnormalities related to Metabolic syndrome and have significant evidence of moderate to advanced carotid atherosclerosis. This was a cross- sectional descriptive study on 72 non- alcoholic patients with fatty liver. Carotid doppler was done to assess their intima media thickness and average CIMT for each individual was noted. Correlation of NAFLD with CIMT was undertaken and the common confounding factors like diabetes, hypertension, dyslipidaemia, metabolic syndrome and impaired fasting glucose among the study subjects was assessed using appropriate statistical methods. Most of the study subjects were in the age group of 41-50 and 51-60 years with slight female predominance. Most of them (79.2%) did not have any symptoms pertaining to the fatty liver perse and were diagnosed incidentally while having presented for other problems. CIMT was increased in 91.7% of these individuals and 73.6% of them demonstrated carotid plaques. Significant percentage of the study population had other risk factors known to affect the carotid intima media thickness namely dyslipidemia and metabolic syndrome (88.88%), hypertension (73.69%), diabetes (61.1%) and impaired fasting glucose (259%6). Mean CIMT in patients with one or more of the above risk factors was significantly more than patients with fatty liver and no risk factors. In this study, there exists a significant correlation between non- alcoholic fatty liver and carotid atherosclerosis. However an independent association between the two could not be estimated due to the presence of other confounding factors in the study population. Patients with NAFLD having increased CIMT could be candidates not only for aggressive treatment of the liver disease, but also for cholesterol lowering strategies and aggressive treatment of cardiovascular disease risk factors. Life style modification, including weight reduction and pharmacological intervention (insuli