Bhawariya Sunil, Bhardwaj Arshia, Singh Arshdeep, Sharma Riya, Kapoor Rajiv, Bawa Ashutosh, Joshi Liza, Bhardwaj Gopal
General Medicine, General Hospital Sector 6 Panchkula, Panchkula, IND.
Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, IND.
Cureus. 2025 Jul 23;17(7):e88636. doi: 10.7759/cureus.88636. eCollection 2025 Jul.
Subclinical atherosclerosis in metabolic dysfunction-associated steatotic liver disease (MASLD) is well established. However, its presence in patients with metabolically healthy non-alcoholic fatty liver disease (MH-NAFLD) remains unclear.
To determine the prevalence of subclinical atherosclerosis in patients with MH-NAFLD and to evaluate whether higher grades of hepatic steatosis are associated with increased carotid intima-media thickness (CIMT).
In this prospective observational study, adults with ultrasonography (USG)-confirmed hepatic steatosis and no components of metabolic syndrome were compared with age- and sex-matched healthy controls. Hepatic steatosis was quantified using MRI-proton density fat fraction (MRI-PDFF), and subclinical atherosclerosis was assessed via CIMT. A CIMT ≥ 0.84 mm was considered elevated. Associations were evaluated using Spearman's correlation and hierarchical linear regression.
A total of 100 participants (median age 36.5 years, IQR 29.0-45.25) were enrolled: 50 with MH-NAFLD (28, 56% males) and 50 matched controls (31, 62% males). MRI-PDFF stratified MH-NAFLD patients as Grade 0 (8, 16%), Grade 1 (23, 46%), Grade 2 (11, 22%), and Grade 3 (8, 16%). Elevated CIMT was observed in 13 (26%) MH-NAFLD participants vs 1 (2%) control (p = 0.001). None of the patients with Grade 0 steatosis had elevated CIMT, whereas all with Grade 3 did. MRI-PDFF grading showed a strong correlation with CIMT (ρ = 0.80, p < 0.0001). In hierarchical regression, MRI-PDFF significantly improved CIMT prediction (ΔR² = 0.39, p < 0.001), while USG lost statistical significance.
MH-NAFLD is associated with increased CIMT. MRI-PDFF is a superior predictor of subclinical atherosclerosis compared to USG, highlighting its utility for vascular risk stratification.
代谢功能障碍相关脂肪性肝病（MASLD）中的亚临床动脉粥样硬化已得到充分证实。然而，其在代谢健康的非酒精性脂肪性肝病（MH-NAFLD）患者中的存在情况仍不明确。
确定MH-NAFLD患者中亚临床动脉粥样硬化的患病率，并评估更高程度的肝脂肪变性是否与颈动脉内膜中层厚度（CIMT）增加相关。
在这项前瞻性观察研究中，将经超声检查（USG）确诊为肝脂肪变性且无代谢综合征成分的成年人与年龄和性别匹配的健康对照进行比较。使用磁共振成像-质子密度脂肪分数（MRI-PDFF）对肝脂肪变性进行量化，并通过CIMT评估亚临床动脉粥样硬化。CIMT≥0.84mm被视为升高。使用Spearman相关性分析和分层线性回归评估相关性。
共纳入100名参与者（中位年龄36.5岁，四分位间距29.0 - 45.25）：50例MH-NAFLD患者（28例，56%为男性）和50例匹配的对照（31例，62%为男性）。MRI-PDFF将MH-NAFLD患者分为0级（8例，16%）、1级（23例，46%）、2级（11例，22%）和3级（8例，16%）。13例（26%）MH-NAFLD参与者出现CIMT升高，而对照中为1例（2%）（p = 0.001）。0级脂肪变性患者均无CIMT升高，而3级患者均有。MRI-PDFF分级与CIMT显示出强相关性（ρ = 0.80，p < 0.0001）。在分层回归中，MRI-PDFF显著改善了CIMT预测（ΔR² = 0.39，p < 0.001），而USG失去了统计学意义。
MH-NAFLD与CIMT增加相关。与USG相比，MRI-PDFF是亚临床动脉粥样硬化的更好预测指标，突出了其在血管风险分层中的作用。
