The association between non-alcoholic fatty liver disease (NAFLD) and carotid-intima media thickness (CIMT) in type 2 diabetes mellitus and proven coronary artery disease patients / Nurazam Omar

Background and Aims: NAFLD and metabolic syndrome have been shown to have a synergistic impact on the development of atherosclerosis. Carotid intima-media thickness (CIMT) is widely used as a reliable index of subclinical atherosclerosis. The relationships between glycaemic control and degree of steatosis with CIMT in patients with NAFLD remain vague. Thus, this study aimed to determine the prevalence of NAFLD and the associated factors including CIMT among a high risk population of type 2 diabetes mellitus (T2DM) with established coronary artery disease (CAD).
Materials and Methods. This is a cross-sectional study involving Type 2 DM patients between 18 to 65 years old who had established CAD based on coronary angiogram, dobutamine stress echocardiogram or exercise stress test (n=150). Patients with seropositive Hepatitis B or Hepatitis C, and significant alcohol intake were excluded. Baseline blood investigations were performed. All participants underwent ultrasonography of the abdomen by 2 independent radiologists for diagnosis of fatty liver, and further graded into moderate (NAFLD-2), mild (NAFLD-1) and no steatosis (non-NAFLD). B-mode ultrasonography of both common carotid arteries was also performed, with calculation of the average posterior wall intima media thickness of the right and left common carotid arteries to determine CIMT.