Correlation Between Hepatic Steatosis and Liver Fibrosis With Carotid Intima-Media Thickness and Carotid Plaques in Patients With Non-Alcoholic Liver Disease

Background: Nonalcoholic fatty liver disease (NAFLD) is currently the leading cause of chronic liver disease. Approximately 10 to 30% of patients with NAFLD progress to Nonalcoholic steatohepatitis (NASH). NASH can lead to liver fibrosis, progression to cirrhosis and hepatocellular carcinoma, and eventually death. In addition, NAFLD also increases the risk of cardiovascular diseases such as angina, myocardial infarction and stroke 1.64 times higher than patients without NAFLD. Determining the correlation between NAFLD and carotid intima-media thickness will indirectly contribute to demonstrating the association between NAFLD and cardiovascular risk factors. Objectives: Determine the proportion of NAFLD patients with carotid intima-media thickness (CIMT) ≥ 0.8 mm. Investigation of the correlation between the hepatic steatosis and liver fibrosis by FibroScan - CAP with CIMT in NAFLD patients. Determination of predictive risk factors of CIMT ≥ 0.8 mm in NAFLD patients. Method: Prospective study on 182 NAFLD patients aged 18 years and older who visited Dai Phuoc General Clinic from January 2023 to June 2023. Results: The proportion of NAFLD patients with CIMT ≥ 0.8 mm was 45.1%. The proportion of NAFLD patients with carotid atherosclerosis was 44.0%. There was a positive, strong correlation (r = 0.61) between the hepatic steatosis measured by FibroScan - CAP and CIMT in NAFLD patients. There is a positive, weak correlation (r = 0.37) between liver fibrosis measured by FibroScan and CIMT in NAFLD patients. Age, hypertension, central obesity, and hepatic steatosis were independent risk factors predicting CIMT ≥ 0.8 mm in NAFLD patients. Conclusion: There is a strong positive correlation between the hepatic steatosis measured by FibroScan - CAP and CIMT in NAFLD patients. Carotid doppler ultrasound to measure CIMT, evaluate carotid atherosclerosis should be undergone in NAFLD patients with risk factors such as older age, hypertension, central obesity and hepatic steatosis.