To Determine the Prevalence and Correlation of Atherosclerosis in Patients with Nonalcoholic Fatty Liver Disease

Liver fibrosis is an important component in nonalcoholic fatty liver disease (NAFLD) patients. Liver biopsy is the gold standard of liver fibrosis evaluation, but it is not done routinely.

This study intends to correlate the liver stiffness assessed using FibroScan with carotid intima-media thickness in NAFLD patients so that timely intervention can be done to prevent cardiac complications.

Patients attending the Outpatient Department and also admitted to the ward of Dayanand Medical College and Hospital, Ludhiana, undergoing fibroscan for the evaluation of NAFLD and subsequent carotid intimal-medial thickness (CIMT) were included. Carotid intimal-medial thickness was measured by a single observer using B-mode on a Philips Affiniti 50C USG machine. A thickness of >0.9 mm was considered a significant thickness and a risk marker for atherosclerosis.

Ultrasound grading showed increasing severity of fatty liver with fibrosis, with Grade III fatty liver present in 0% of F0-F1, 29.6% of F2, and 70.4% of F3 patients. Both right and left carotid intima-media thickness (CIMT) increased significantly with advancing fibrosis. Both right and left CIMT increased significantly with advancing fibrosis ( P = 0.001). Waist circumference also showed a significant rise across fibrosis stages ( P = 0.001). Serum cholesterol, triglycerides, low-density lipoprotein cholesterol, and fasting blood sugar levels increased with fibrosis severity, while high-density lipoprotein cholesterol decreased significantly ( P = 0.005).

In conclusion, a higher grade of liver fibrosis assessed by transient elastography can be a risk factor for atherosclerosis.