Association Between Non-Alcoholic Fatty Liver Disease and Subclinical Atherosclerosis: A Study of Carotid Intima-Media Thickness

Background: Non-alcoholic fatty liver disease (NAFLD) is a major contributor to chronic liver disease worldwide. It is associated with metabolic syndrome, central obesity, insulin resistance, hypertension, hyperlipidemia, and cardiovascular risks. Carotid intima-media thickness (CIMT) is a recognized surrogate marker for atherosclerosis and cardiovascular risk. Objective: To evaluate the CIMT in patients diagnosed with NAFLD, highlighting potential pathophysiological correlations and clinical implications. Methods: A cross-sectional study was conducted at Al Kindy Teaching Hospital over 4 months from October 2023 to February 2024. The sample size was 100 patients showing ultrasonic signs of fatty liver changes (44 were males and 56 were females). These patients underwent carotid Doppler ultrasound, and the intima-media thickness was measured. Results: Of the 100 patients, 53 had a CIMT greater than 0.08 cm, 23 had grade I fatty liver, 24 had grade II fatty liver, and 6 had grade III fatty liver. Of the 47 patients with a CIMT < 0.08 cm, 16 had grade II fatty liver and 31 had grade I fatty liver. The results were statistically significant (p=0.015). The logistic regression shows a higher fatty liver stage significantly associated with increased IMT, but BMI is not significantly associated with thickened carotid intima-media. Conclusions: NAFLD patients exhibit a higher propensity for subclinical atherosclerosis, as evidenced by increased CIMT, and its monitoring may serve as a valuable noninvasive tool in cardiovascular risk stratification, especially in metabolically compromised NAFLD populations.