Relation of nonalcoholic hepatic steatosis to early carotid atherosclerosis in healthy men: role of visceral fat accumulation.

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome that is closely associated with obesity, dyslipidemia, insulin resistance, and type 2 diabetes, thus suggesting that NAFLD represents another component of the metabolic syndrome (1,2). Because it is now recognized that individuals with the metabolic syndrome are at increased cardiovascular risk (3–5), it is possible to hypothesize that NAFLD patients might portend a greater cardiovascular disease (CVD) risk. Ultrasonographically measured carotid intima-media thickness (CIMT), as a reliable index of subclinical atherosclerosis (6), can be used to characterize the CVD risk of patients with NAFLD. However, the available data on this specific topic are lacking. We compared CIMT values in subjects with and without nonalcoholic hepatic steatosis (HS) and examined whether such differences were mediated by one or more metabolic disorders typically clustering in these subjects. We studied 85 male volunteers who were randomly selected among those who agreed to have an evaluation of their liver and intra-abdominal fat by ultrasonography and computed tomography (CT) scan, respectively. The exclusion criteria were as follows: age >50 years combined with an alcohol consumption ≥20 g/day, taking any drugs, and a history of recent acute illness or clinical evidence suggestive of any cardiovascular events, diabetes, or kidney or liver disorders. All individuals were clinically healthy. Most subjects were abstainers ( n = 68) or drank minimally …