B-Mode Ultrasound Grading of Nonalcoholic Fatty Liver Disease and Association with Intima-media Thickness: A Case–Control Study

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Abstract Background: Nonalcoholic fatty liver disease (NAFLD) is the infiltration of the liver cells with fat of up to at least 5% and above. It is the type of fatty infiltration that is, not associated with alcohol intake, and is the “hepatic expression” of a metabolic syndrome that affects a wide spectrum of people. It is now a disease entity in today’s society, as it is fast becoming an emerging public health problem in the medical community. This is a result of the changing life patterns in society. The incidence and prevalence of cardiovascular anomalies as depicted by changes in the vascular walls of blood vessels has been linked with NAFLD. Objective: To determine the association between NAFLD and carotid intima-media thickness (CIMT) among adult Nigerians. Subjects and Methods: This was a case–control study involving 181 apparently healthy subjects with NAFLD and an equal number of apparently normal subjects without NAFLD matched for age and gender. The CIMT was assessed in both groups. This makes for a total number of 362 subjects. They were recruited from ABUTH’s staff members and students and the General Out-patient/Family Medicine Clinic of ABUTH, Zaria. This study was approved by the Ethical Committee of ABUTH, and all patients signed informed consent prior to their enrollment. Results: A total of 362 subjects were involved in the study. Both the NAFLD patients and control populations had 98 (54.1%) females and 83 (45.9%) males each, with the age range of both between 20 and 70 years of age. The Wilcoxon matched-pairs comparison test showed no significant difference in the ages of the two study groups. The development of NAFLD had significant association with age, subject’s occupation and area of residence, while there was no significant Association of development of NAFLD with sex, marital status and educational attainment. Also, there was statistically significant increase in CIMT in subjects with NAFLD when compared with the control group (P ≤ 0.0001). The values suggested a steady increase with progression from mild, moderate to severe NAFLD. Conclusion: Our study showed a statistically significant increase of association between nonalcoholic fatty liver disease (NAFLD) and CIMT when compared with the control group in our environment.