Kumar Ramesh, Narayan Ruchika
Gastroenterology, All India Institute of Medical Sciences, Patna, IND.
Radiodiagnosis, All India Institute of Medical Sciences, Patna, IND.
Cureus. 2024 Sep 2;16(9):e68439. doi: 10.7759/cureus.68439. eCollection 2024 Sep.
There is a significant association of non-alcoholic fatty liver disease (NAFLD) with cardiovascular disease (CVD). Most CVDs begin with atherosclerosis in the arteries, which can be reliably measured as the carotid intima-media thickness (CIMT) by ultrasound. Given that ethnic and regional differences have an impact on NAFLD, we aimed to evaluate the association of NAFLD patients from India with subclinical atherosclerosis, measured as CIMT. A thorough literature search was performed on four electronic databases using combinations of several keywords. The relevant data were pooled in a random or fixed-effect model, based on heterogeneity, to calculate the pooled standardised mean difference (SMD), or odds ratio (OR) with 95% confidence interval (CI). The final analysis included a total of 15 studies with 1196 NAFLD and 1482 control subjects. NAFLD patients had a 21.3% higher mean CIMT than the controls. The pooled SMD was 1.001 (95% CI: 0.627-1.375, p < 0.001). Three studies that balanced cardiometabolic risk factors found a similar association (p = 0.037). Furthermore, NAFLD was significantly associated with the presence of high (>0.8 mm) CIMT (pooled OR = 5.4, 95% CI: 2.0-14 .9) and carotid plaques (pooled OR = 10.24, 95% CI: 5.74-18.26). The mean CIMT was also higher in diabetic NAFLD than in the diabetic control (pooled SMD = 1.07, 95% CI = 0.818-1.324, p < 0.001). There is a significant positive association between the marker of subclinical atherosclerosis and NAFLD in India. This might give more light on screening and follow-up plans for such patients.
非酒精性脂肪性肝病（NAFLD）与心血管疾病（CVD）之间存在显著关联。大多数心血管疾病始于动脉粥样硬化，通过超声可可靠地将其测量为颈动脉内膜中层厚度（CIMT）。鉴于种族和地区差异会对NAFLD产生影响，我们旨在评估来自印度的NAFLD患者与以CIMT衡量的亚临床动脉粥样硬化之间的关联。使用多个关键词组合在四个电子数据库上进行了全面的文献检索。根据异质性，将相关数据汇总到随机或固定效应模型中，以计算汇总标准化均值差（SMD）或比值比（OR）以及95%置信区间（CI）。最终分析共纳入15项研究，涉及1196例NAFLD患者和1482例对照受试者。NAFLD患者的平均CIMT比对照组高21.3%。汇总SMD为1.001（95%CI：0.627 - 1.375，p < 0.001）。三项对心血管代谢危险因素进行了平衡的研究发现了类似的关联（p = 0.037）。此外，NAFLD与CIMT高（>0.8 mm）的存在（汇总OR = 5.4，95%CI：2.0 - 14.9）和颈动脉斑块（汇总OR = 10.24，95%CI：5.74 - 18.26）显著相关。糖尿病性NAFLD患者的平均CIMT也高于糖尿病对照组（汇总SMD = 1.07，95%CI = 0.818 - 1.324，p < 0.001）。在印度，亚临床动脉粥样硬化标志物与NAFLD之间存在显著正相关。这可能为这类患者的筛查和随访计划提供更多线索。
