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World J Gastroenterol. Mar 28, 2005; 11(12): 1848-1853
Published online Mar 28, 2005. doi: 10.3748/wjg.v11.i12.1848
Hepatic steatosis is associated with an increased risk of carotid atherosclerosis
Henry Völzke, Daniel M. Robinson, Volker Kleine, Roland Deutscher, Wolfgang Hoffmann, Jan Lüdemann, Ulf Schminke, Christof Kessler, Ulrich John
Henry Völzke, Ulrich John, Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University Greifswald, Germany
Daniel M. Robinson, Volker Kleine, Roland Deutscher, Department of Internal Medicine B, Ernst Moritz Arndt University Greifswald, Germany
Wolfgang Hoffmann, Institute for Community Medicine, Ernst Moritz Arndt University Greifswald, Germany
Jan Lüdemann, Institute of Clinical Chemistry and Laboratory Medicine, Ernst Moritz Arndt University Greifswald, Germany
Ulf Schminke, Christof Kessler, Department of Neurology, Ernst Moritz Arndt University Greifswald, Germany
Author contributions: All authors contributed equally to the work.
Supported by Community Medicine Research net (CMR) of the University of Greifswald, which is funded by the Federal Ministry of Education and Research and the Federal State of Mecklenburg-West Pomerania
Correspondence to: PD Henry Völzke, M.D., Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Walther Rathenau Str. 48, D-17487 Greifswald, Germany. voelzke@uni-greifswald.de
Telephone: +49-3834867707 Fax: +49-3834866684
Received: August 24, 2004
Revised: August 25, 2004
Accepted: November 19, 2004
Published online: March 28, 2005
Abstract

AIM: Although an association between hepatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships.

METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years. A study population of 4222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound.

RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged ≥45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001). This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption.

CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.

Keywords: Hepatic steatosis; Fatty liver; Atherosclerosis; Study of Health in Pomerania