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July 5, 2026Indian Journal of Public Health0 citationsOpen Access

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

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YGYogesh Kumar GuptaSNSahil NohriaVMVarun Mehta

Key Result

Advancing liver fibrosis assessed by transient elastography was significantly associated with increased right and left carotid intima-media thickness (P=0.001) in patients with NAFLD.

Key Points

  • The study aims to determine the relationship between liver stiffness and carotid intima-media thickness in patients with nonalcoholic fatty liver disease.
  • Included NAFLD patients undergoing FibroScan and carotid intimal-medial thickness measurements.
  • Measured CIMT using B-mode ultrasound on a Philips Affiniti 50C USG machine.
  • Assessed liver fibrosis based on severity grades (F0-F3) and corresponding ultrasound findings.
  • CIMT increased significantly with advancing fibrosis stages; P=0.001 for both sides.
  • Serum cholesterol and triglyceride levels elevated while HDL cholesterol decreased with fibrosis (P=0.005).
  • Grade III fatty liver observed in 70.4% of F3 patients, correlating increased severity with atherosclerosis risk.

Study Design

Type

Observational

Multicenter

No

Structured PICO

Does liver fibrosis severity correlate with carotid intima-media thickness in patients with NAFLD?

P
Population
Patients with nonalcoholic fatty liver disease undergoing fibroscan and carotid intimal-medial thickness evaluation.
E
Exposure
Liver stiffness assessment using FibroScan (transient elastography)
O
Outcome
Correlation of liver stiffness (fibrosis stage) with carotid intima-media thickness (CIMT)surrogate

Higher grades of liver fibrosis assessed by transient elastography correlate with increased carotid intima-media thickness, suggesting it can serve as a risk marker for atherosclerosis in NAFLD patients.

Main Result

p-value: p=0.001

Abstract

Abstract Background: 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. Objectives: 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. Materials and Methods: 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. Results: 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). Conclusion: In conclusion, a higher grade of liver fibrosis assessed by transient elastography can be a risk factor for atherosclerosis.

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Cite This Study

Gupta et al. (2026) conducted an observational in Nonalcoholic fatty liver disease (NAFLD). Liver fibrosis severity vs. Lower grades of fibrosis was evaluated on Carotid intima-media thickness (CIMT) (p=0.001). Advancing liver fibrosis assessed by transient elastography was significantly associated with increased right and left carotid intima-media thickness (P=0.001) in patients with NAFLD.

synapsesocial.com/papers/6a49f6c9f5d1d45b28800fc5https://doi.org/10.4103/ijph.ijph_824_25
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Relationship between Carotid Artery Stenosis and the Severity of Fatty Liver in Patients with Coronary Artery Disease Who Are Candidates for Angiography2025
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  3. 3Association between non‐alcoholic fatty liver disease evaluated by transient elastography with extracranial carotid atherosclerosis in a multiethnic Asian community2018 · 19 citations
  4. 4Association between Nonalcoholic Fatty Liver Disease Severity Assessed by Fibroscan and Atherosclerotic Cardiovascular Disease Risk Score2025
  5. 5Associations Between Liver Histology and Early Carotid Atherosclerosis in Subjects With Nonalcoholic Fatty Liver Disease *2005 · 24 citations