Relationship between CIMT and liver fibrosis in subjects with NAFLD

Background and Aim: Studies have shown that cardiovascular disease dictates the outcome in NAFLD patients more frequently and to a greater extent than does the progression of liver disease. CIMT (Carotid intima media thickness) is regarded as surrogate marker of coronary atherosclerosis. Liver biopsy is the gold standard of liver fibrosis evaluation, but it is a painful and invasive procedure. Liver stiffness (LS) measurement using transient elastography (TE) has emerged as a promising noninvasive tool for assessing the degree of liver fibrosis. 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. Methods: A total of 100 NAFLD patients were enrolled into the study. All subjects underwent clinical evaluation, biochemical testing, anthropometry, ultrasound carotid Doppler, and Fibroscan examination. Results: Out of 100 patients 48 were female and 52 were male with mean age of 49.07± 9.345 years. Majority were asymptomatic (67%) followed by Rt upper quaant pain (28%) and fatigue (22%). Grade 1 fatty liver was seen in 47% patients while Grade 2 fatty liver was found in 20% and Grade 3 fatty liver in 33%. Most of them had F0-F1 fibrosis (53), F2 fibrosis was present in 28% while F3 fibrosis was seen in 19 percent of patients. Patients with F3 fibrosis on TE were found to have markedly greater CIMT values (P value <0.001) as compared to F1 and F2 fibrosis groups. Conclusions: Individuals with higher grade of fibrosis are strongly associated with increased CIMT