Carotid lesions in outpatients with nonalcoholic fatty liver disease

To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease (NAFLD) at abdominal ultrasound (US).

One hundred and fifty-four consecutive outpatients (age range 24-90 years, both sexes) referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness (c-IMT) and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography.

Higher c-IMT values were found in the presence of NAFLD (90 patients), even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors (0.84 +/- 0.10 mm vs 0.71 +/- 0.10 mm, P < 0.001). The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition (P = 0.02). The adjusted relative risk of having carotid plaques for patients with NAFLD was 1.85 (95% CI: 1.33-2.57, P < 0.001).

An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.