Rasool Abid, Dar Waseem, Latief Muzamil, Dar Imtiyaz, Sofi Najeebullah, Khan Mushtaq Ahmad
Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Brain Circ. 2017 Jan-Mar;3(1):35-40. doi: 10.4103/bc.bc_28_16. Epub 2017 Mar 29.
Nonalcoholic fatty liver disease (NAFLD) is a frequently encountered clinical condition in clinical practice, particularly in obese and diabetic patients. Carotid atherosclerosis is regarded as surrogate marker of coronary atherosclerosis. We aimed to know whether evaluation for carotid atherosclerosis should be done in all patients of NAFLD.
A total of 200 NAFLD patients and 100 age- and sex-matched controls were enrolled into the study. Ultrasound was done to document fatty liver and carotid intimal thickness, and relation between these two was observed.
Grade 1 fatty liver was seen in 36% patients while Grade 2 fatty liver was found in 39% and Grade 3 fatty liver in 25%. Patients with Grade 1 fatty liver had left intima-media thickness (IMT) in the range of 0.4-0.6 mm (mean IMT - 0.69 mm) and had right IMT in the range of 0.5-0.8 mm (mean IMT - 0.71 mm). In patients with Grade 2 fatty liver, left IMT was in the range of 0.6-1.0 mm (mean IMT - 0.80 mm) and right IMT in the range of 0.7-1.0 mm (mean IMT - 0.84 mm), while in patients with Grade 3 fatty liver, left IMT was in the range of 0.8-1.2 mm (mean IMT - 0.93 mm) and right IMT in the range of 0.9-1.4 mm (mean IMT - 0.99 mm). Among controls, the mean left IMT was 0.579 mm and mean right IMT was 0.575 mm.
The level of carotid intimomedial thickness was more in cases than in controls and progressively increased with the grade of fatty liver which was statistically significant.
非酒精性脂肪性肝病（NAFLD）是临床实践中常见的临床病症，尤其是在肥胖和糖尿病患者中。颈动脉粥样硬化被视为冠状动脉粥样硬化的替代标志物。我们旨在了解是否应对所有NAFLD患者进行颈动脉粥样硬化评估。
共纳入200例NAFLD患者和100例年龄及性别匹配的对照者进行研究。采用超声检查记录脂肪肝情况及颈动脉内膜厚度，并观察两者之间的关系。
36%的患者为1级脂肪肝，39%为2级脂肪肝，25%为3级脂肪肝。1级脂肪肝患者的左侧内膜中层厚度（IMT）在0.4 - 0.6毫米范围内（平均IMT - 0.69毫米），右侧IMT在0.5 - 0.8毫米范围内（平均IMT - 0.71毫米）。2级脂肪肝患者的左侧IMT在0.6 - 1.0毫米范围内（平均IMT - 0.80毫米），右侧IMT在0.7 - 1.0毫米范围内（平均IMT - 0.84毫米），而3级脂肪肝患者的左侧IMT在0.8 - 1.2毫米范围内（平均IMT - 0.93毫米），右侧IMT在0.9 - 1.4毫米范围内（平均IMT - 0.99毫米）。在对照组中，左侧平均IMT为0.579毫米，右侧平均IMT为0.575毫米。
病例组的颈动脉内膜中层厚度水平高于对照组，且随着脂肪肝等级的升高而逐渐增加，差异具有统计学意义。
