Fatty liver, carotid disease and gallstones: A study of age-related associations

Table 1 Ultrasonographic carotid findings in subjects with or without fatty liver of unspecified etiology

	Fatty liver
Carotid findings	Absent n (%)	Present n (%)	P
Normal	19 (7.3)	39 (20.6)
IMT	27 (10.4)	45 (23.8)
Plaques	214 (82.3)	105 (55.6)	P = 4.65 × 10-10

χ² test.

Table 2 Median age and 25^th-75^th percentile of subjects with/without fatty liver of unspecified etiology (classified according to carotid findings)

	Fatty liver
Carotid findings	Absent n (%)	Present n (%)
Normal	44 (31-52)	46 (34-58)
IMT	65 (51-71)	56 (48-62.5)
Plaques	76 (68.75-82)	68 (60.5-78)

Table 3 Carotid ultrasonographic findings in subjects with or without gallstone disease

	Gallstone disease
arotid findings	Absent n (%)	Present n (%)	P
Normal	48 (15.8)	10 (6.8)
IMT	51 (16.8)	21 (14.4)
Plaques	204 (67.3)	115 (78.8)	P = 0.015

χ² test.

Table 4 Independent predictors of intima-media thickening (IMT) or plaques in fatty liver of unspecified etiology

Carotidfindings		B	Standarderror	P	Exp (B)(95% CI )
IMT	Intercept	-3.736	0.916	0.000
	Male	-0.019	0.405	0.962	0.981 (0.443-2.169)
	Age	0.079	0.016	0.0000014	1.082 (1.048-1.117)
	Fatty liver	0.093	0.426	0.827	0.911 (0.395-2.101)
Plaques	Intercept	-7.879	1.050	0.000
	Male	0.042	0.403	0.1719	1.719 (0.781-3.786)
	Age	0.166	0.018	2.27 × 10-20	1.181 (1.040-1.223)
	Fatty liver	0.873	0.416	0.036	0.418 (0.185-0.945)

Multivariate multinominal logistic regression. Dependent variable: carotid findings (IMT or plaques). Reference category: normal carotid findings. Age, sex (forced entry terms), fatty liver and GD (forward entry term) were entered as covariates.

Table 5 Historical, anthropometric and laboratory findings of subjects with NAFLD as a function of ultrasonographic carotid findings (mean ± SE, 25^th-75^th percentile)

Variable	Normal(n 19)	IMT(n 30)	Plaques(n 16)	P
Age (yr)	46.11 ± 2.66	55.23 ± 1.59	58.69 ± 2.67	0.001
Gender (M/F)	10/9	13/17	8/8	NS
Smokers	8/17	10/30	6/16	NS
Physical exercise	5/17	11/30	6/16	NS
BMI (kg/m2)	31.05 ± 1.40	28.85 ± 0.68	27.30 ± 0.85	NS
Mass (kg)	87.21 (76.00-100.00)	79.9 (71.00-88.50)	74.28.50 (66.50–84.00)	0.026
Waist (cm)	102.53 ± 2.73	96.81 ± 2.02	95.31 ± 2.19	NS
Hip (cm)	114.79 ± 3.31	109.30 ± 1.52	107.31 ± 1.44	NS
W/H ratio	0.90 ± 0.02	0.89 ± 0.01	0.89 ± 0.02	NS
Arterial pressure (mmHg)	D: 80.0 (70.0-80.0) S: 120.0 (120.0-130.0)	D: 80.0 (80.0-80.0) S: 130.0 (120.0-130.0)	D: 80.00 (80.00-87.5) S: 130.0 (120.0-145.0)	NS
Fasting glucose (mmol/L)	5.55 (4.75-6.54)	5.39 (5.05-5.83)	5.28 (4.99-5.65)	NS
Uric acid (μmol/L)	345.29 ± 21.76	333.52 ± 14.11	315.88 ± 18.23	NS
Total cholesterol (mmol/L)	5.37 ± 0.26	4.15 ± 0.21	5. 91 ± 0.18	NS
HDL Cholesterol (mmol/L)	1.20 ± 0.06	1.25 ± 0.06	1.21 ± 0.06	NS
Triglycerides (mmol/L)	1.46 (0.99-2.05)	1.49 (1.18-1.98)	1.64 (1.49 - 2.00)	NS
AST (IU/L)	26.00 (23.00-35.00)	25.00 (21.00-31.50)	23.50 (19.50-29.50)	NS
ALT (IU/L)	53.00 (35.00-74.00)	39.00 (29.50-54.00)	36.00 (23.25-40.00)	NS
GGT (IU/L)	40.00 (29.00-71.00)	30.00 (21.00-71.00)	33.00 (24.25-49.25)	NS
Fasting insulin (pmol/L)	119.82 (86.81-145.65)	108.70 (79.28-164.88)	80.71 (60.62-109.77)	NS
Insulin 120 min post-load (pmol/L)	499.38 (269.78-1442.18)	767.72 (324.31-1379.39)	554.26 (383.50-770.45)	NS
APO A (mg/dL)	139.80 ± 7.73	144.58 ± 4.74	137.64 ± 6.03	NS
APO B (mg/dL)	98.00 ± 6.61	111.15 ± 5.04	110.73 ± 6.39	NS
Iron (μmol/L)	16.34 ± 1.04	16.58 ± 0.89	15.99 ± 1.39	NS
Ferritin (mg/dL)	122.68 ± 23.64	129.00 ± 17.95	175.36 ± 30.22	NS
Transferrin saturation (%)	25.99 ± 1.72	29.33 ± 1.80	28.17 ± 2.86	NS
Fibrinogen (g/L)	3.16 ± 0.18	3.53 ± 0.14	3.33 ± 0.22	NS
HOMA-IR index	4.207 (2.936-5.941)	3.864 (2.708-5.869)	2.815 (2.256-3.861)	NS
Lp(a) (mg/dL)	35.00 (8.50-77.00)	12.00 (4.00-30.00)	9.00 (5.50-28.5)	NS

Significance of the comparisons evaluated through oneway Scheffe’s test for variable normally distributed, and Kruskall Wallis for those not normally distributed.

Table 6 NAFLD. Hepatic histological findings in NAFLD patients with normal carotid findings, intima-media thickening (IMT) and atherosclerotic carotid plaques¹

Hepatic histology	Carotid findings
	Normal n (%)	IMT n (%)	Plaques n (%)	p
Inflammatory grade
0	2 (29)	1 (10)	2 (33)
1	3 (43)	5 (50)	2 (33)
2	2 (29)	2 (20)	2 (33)
3	0 (0)	2 (20)	0 (0)	0.5162
Fibrosis stage
0	5 (71)	7 (70)	5 (83)
1	1 (14)	1 (10)	1 (17)
2	1 (14)	2 (20)	0
3	0	0	0
4	0	0	0	0.7622
Steatosis extent (%)	45.8 ± 9.9	51.0 ± 8.9	23.00 ± 5.4	0.1313

¹23 of 65 NAFLD patients underwent liver biopsy; 7 had normal findings, 10 IMT, and 6 carotid plaques.

²Kruskall-Wallis test;

³One way analysis of variance.

Table 7 Independent predictors of intima-media thickening (IMT) or plaques in NAFLD subjects

Carotid			Standard		Exp (B)
findings		B	error	P1	(95% CI )
IMT	Intercept	-0.955	2.648	0.718
	Age	0.087	0.034	0.010	1.091 (1.021-1.165)
	BMI	-0.102	0.071	0.150	0.903 (0.785-1.038)
Plaques	Intercept	-0.913	3.628	0.801
	Age	0.119	0.042	0.005	1.126 (1.037-1.223)
	BMI	-0.189	0.097	0.052	0.828 (0.684-1.002)

¹Multivariate multinominal logistic regression. Dependent variable: carotid findings (IMT or plaques). Reference category: normal carotid findings. Age, body mass (forced entry terms) and HOMA (forward entry term) were entered as covariates.