Non-alcoholic fatty liver disease, bulb carotid intima-media thickness and obesity phenotypes: results of a prospective observational study.

Abstract

The objective of this prospective study was to assess the correlation between carotid intima-media thickness at thecommon carotid (CIMTc) and carotid bifurcation (CIMTb) level, hepatic fat accumulation, and obesity phenotypes. Two hundred obese adults, in which CIMTc and CIMTb thickness was determined, were included. Accordingto body mass index (BMI) and presence of metabolic syndrome (MetS), patients were classified as metabolically healthy obese(MHO, obesity without MetS) and metabolically unhealthy obese (MUHO, obesity with MetS). MHO patients were furtherclassified as MHO1 (obese with increased waist circumference) and MHO2 (obese with increased waist circumference plusone of the 4 criteria for MetS). Non-alcoholic fatty liver disease (NAFLD) presence was assessed by fatty liver index (FLI).RESULTS: CIMTc and CIMTb increased with obesity phenotypes from 0.74 mm and 1.04 mm in MHO1 to 0.84 mm and 1.23mm in MHO2 and 0.88 mm and 1.74 mm in MUHO. Obesity phenotypes were significantly correlated with CIMTb. NAFLDfrequency increased from 66.0% in the MHO1 to 73.0% in the MHO2 and 84.2% in the MUHO (p<0.05). Independent of age,BMI, total cholesterol, HbA1c, and HOMA-IR, the CIMTc was significantly associated with FLI in all obesity phenotypesand CIMTb only in MHO2 and MUHO. Our results suggest that subclinical atherosclerosis varies according toobesity phenotypes and is correlated with the hepatic fat accumulation.