Association Between Fatty Liver Disease and Carotid Atherosclerosis in Patients with History of Stroke

摘要

Background: nonalcoholic fatty liver disease is a clinic-pathological syndrome closely associated with obesity, dyslipidemia, diabetes and atherosclerosis. Some authors suggest that NAFLD is, in fact, another component of the metabolic syndrome. We examined the prevalence of NAFLD, and whether NAFLD associates with carotid injury, in a group of patients after ischemic stroke. Methods: carotid atherosclerosis and cardiovascular risk factors were measured in 50 patients hospitalized in our clinic for stroke. Hepatic steatosis (HS) and carotid atherosclerosis (intima-media thickness - IMT) were diagnosed by ultrasound examination. Plasma liver function tests and other biochemical blood measurements were determined. Results: 38 from 50 patients had HS (76%), and from these, 24 had IMT over 1 mm (63%); subjects with HS had significantly (P<0.05) greater IMT measurements than those without HS. The former also had higher values for body mass index, diastolic blood pressure and mean blood pressure and triglycerides, and lower HDL cholesterol concentration. Behavioral variables (smoking, diet, and sedentarism), fasting plasma glucose, and LDL cholesterol levels did not significantly differ between subjects with and without HS. Older age and the presence of HS, were independent predictors of an increased IMT. Conclusion: patients with HS in our study showed a cluster of cardiovascular risk factors and significant carotid atherosclerosis (increased IMT). The detection of HS by abdominal ultrasound should alert to the existence of a higher cardiovascular risk. Both HS and IMT are non invasive low cost and highly reproducible procedures which should be performed in those patients to further evaluate cardiovascular risk.