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Volume 40 Issue 8

Aug. 2024

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Abstract

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Article Navigation > Journal of Clinical Hepatology > 2024 > 40(8): 1591-1597

Association of metabolic associated fatty liver disease with carotid atherosclerotic plaque and stenosis

DOI: 10.12449/JCH240814

Department of Gastroenterology，The Second Affiliated Hospital of Kunming Medical University，Kunming 650000，China

Research funding:

Yunnan Province “Ten Thousand Talents Plan” Famous Medical Talents Project (YNWR-MY-2019-074)

More Information

Corresponding author: ZHAO Gongfang， zhaogongfang@163.com （ORCID： 0000-0001-9178-1567）
Received Date: 2023-11-27
Accepted Date: 2024-01-05
Published Date: 2024-08-25

Abstract

Objective To investigate the association between metabolic associated fatty liver disease （MAFLD） and carotid atherosclerotic plaque. Methods A total of 1 107 patients who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from July， 2014 to December， 2022 were enrolled， and all patients underwent abdominal ultrasound and CT angiography of the head and neck arteries. Baseline data and clinical diagnosis were collected， and the patients were divided into MAFLD group with 499 patients and non-MAFLD group with 608 patients based on medical history， clinical tests， and imaging findings. According to the CT value， carotid plaques were classified into calcified plaques， non-calcified plaques， and mixed plaques. According to the NASCET criteria， carotid stenosis was categorized as normal vessel， slight stenosis， mild stenosis， moderate stenosis， and severe stenosis/occlusion. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for carotid atherosclerosis. Results Compared with the non-MAFLD group， the MAFLD group had a significantly higher proportion of patients with calcified plaques （74.3% vs 63.3%， P<0.05）， non-calcified plaques （27.1% vs 17.1%， P<0.05）， or mixed plaques （27.3% vs 20.7%， P<0.05）， as well as a significantly higher proportion of patients with mild stenosis （50.9% vs 44.9%， P<0.05）， moderate stenosis （14.6% vs 8.4%， P<0.05）， or severe stenosis/occlusion （6.6% vs 3.5%， P<0.05）. The univariate logistic regression analysis showed that MAFLD was a risk factor for calcified carotid plaques， non-calcified plaques， and mixed plaques， and it was also a risk factor for mild stenosis， moderate stenosis， and severe stenosis/occlusion of the carotid artery （all P<0.05）. After adjustment for confounding factors， the multivariate Logistic regression analysis showed that MAFLD was an independent risk factor for calcified plaque， non-calcified plaque， mixed plaque， and moderate stenosis of the carotid arteries （all P<0.05）. Conclusion MAFLD is an independent risk factor for moderate stenosis， calcified plaques， non-calcified plaques， and mixed plaques of the carotid arteries.
- Metabolic Associated Fatty Liver Disease,
- Atherosclerosis,
- Carotid Plaque,
- Risk Factors

References

[1]	FILIPOVIC B, MARJANOVIC-HALJILJI M, MIJAC D, et al. Molecular aspects of MAFLD-new insights on pathogenesis and treatment[J]. Curr Issues Mol Biol, 2023, 45( 11): 9132- 9148. DOI: 10.3390/cimb45110573.
[2]	XUE R, FAN JG. Brief introduction of an international expert consensus statement: A new definition of metabolic associated fatty liver disease[J]. J Clin Hepatol, 2020, 36( 6): 1224- 1227. DOI: 10.3969/j.issn.1001-5256.2020.06.007. 薛芮, 范建高. 代谢相关脂肪性肝病新定义的国际专家共识简介[J]. 临床肝胆病杂志, 2020, 36( 6): 1224- 1227. DOI: 10.3969/j.issn.1001-5256.2020.06.007.
[3]	ESLAM M, NEWSOME PN, SARIN SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement[J]. J Hepatol, 2020, 73( 1): 202- 209. DOI: 10.1016/j.jhep.2020.03.039.
[4]	LEI F, WANG XM, WANG CQ, et al. Metabolic dysfunction-associated fatty liver disease increased the risk of subclinical carotid atherosclerosis in China[J]. Front Endocrinol, 2023, 14: 1109673. DOI: 10.3389/fendo.2023.1109673.
[5]	GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Neurol, 2021, 20( 10): 795- 820. DOI: 10.1016/S1474-4422(21)00252-0.
[6]	ZHOU XD, CAI JJ, TARGHER G, et al. Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention[J]. Cardiovasc Diabetol, 2022, 21( 1): 270. DOI: 10.1186/s12933-022-01697-0.
[7]	National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: a 2018 update[J]. J Clin Hepatol, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007. 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
[8]	CUI L, PENG XM, TANG QJ. Analysis of CTA in head and neck in evaluating carotid stenosis and plaque properties in patients with cerebral infarction[J]. Mod Med Imageology, 2021, 30( 4): 715- 717. 崔凌, 彭细美, 唐庆健. 头颈部CTA在评估脑梗死患者颈动脉狭窄及斑块性质的价值分析[J]. 现代医用影像学, 2021, 30( 4): 715- 717.
[9]	CHALASANI N, YOUNOSSI Z, LAVINE JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology, 2018, 67( 1): 328- 357. DOI: 10.1002/hep.29367.
[10]	LEI F, QIN JJ, SONG XH, et al. The prevalence of MAFLD and its association with atrial fibrillation in a nationwide health check-up population in China[J]. Front Endocrinol(Lausanne), 2022, 13: 1007171. DOI: 10.3389/fendo.2022.1007171.
[11]	DELLA TS. Beyond the X factor: Relevance of sex hormones in NAFLD pathophysiology[J]. Cells, 2021, 10( 9): 2502. DOI: 10.3390/cells10092502.
[12]	LEE CB, KIM J, HAN J, et al. Formyl peptide receptor 2 determines sex-specific differences in the progression of nonalcoholic fatty liver disease and steatohepatitis[J]. Nat Commun, 2022, 13( 1): 578. DOI: 10.1038/s41467-022-28138-6.
[13]	GEORGE ES, FORSYTH A, ITSIOPOULOS C, et al. Practical dietary recommendations for the prevention and management of nonalcoholic fatty liver disease in adults[J]. Adv Nutr, 2018, 9( 1): 30- 40. DOI: 10.1093/advances/nmx007.
[14]	QIN S. LDL and HDL oxidative modification and atherosclerosis[M/OL]//JIANG XC. Lipid transfer in lipoprotein metabolism and cardiovascular disease: Vol. 1276. Singapore: Springer Singapore, 2020: 157- 169[2023-11-08]. https://link.springer.com/10.1007/978-981-15-6082-8_10. DOI: 10.1007/978-981-15-6082-8_10
[15]	SAKURAI Y, KUBOTA N, YAMAUCHI T, et al. Role of insulin resistance in MAFLD[J]. Int J Mol Sci, 2021, 22( 8): 4156. DOI: 10.3390/ijms22084156.
[16]	DUAN YM, PAN XF, LUO JY, et al. Association of inflammatory cytokines with non-alcoholic fatty liver disease[J]. Front Immunol, 2022, 13: 880298. DOI: 10.3389/fimmu.2022.880298.
[17]	SATISH M, SAXENA SK, AGRAWAL DK. Adipokine dysregulation and insulin resistance with atherosclerotic vascular disease: Metabolic syndrome or independent sequelae?[J]. J Cardiovasc Transl Res, 2019, 12( 5): 415- 424. DOI: 10.1007/s12265-019-09879-0.
[18]	MU W, CHENG XF, LIU Y, et al. Potential nexus of non-alcoholic fatty liver disease and type 2 diabetes mellitus: Insulin resistance between hepatic and peripheral tissues[J]. Front Pharmacol, 2019, 9: 1566. DOI: 10.3389/fphar.2018.01566.
[19]	KHAN RS, BRIL F, CUSI K, et al. Modulation of insulin resistance in nonalcoholic fatty liver disease[J]. Hepatology, 2019, 70( 2): 711- 724. DOI: 10.1002/hep.30429.
[20]	BIAN F, YANG XY, XU G, et al. CRP-induced NLRP3 inflammasome activation increases LDL transcytosis across endothelial cells[J]. Front Pharmacol, 2019, 10: 40. DOI: 10.3389/fphar.2019.00040.
[21]	POZNYAK AV, BHARADWAJ D, PRASAD G, et al. Anti-inflammatory therapy for atherosclerosis: Focusing on cytokines[J]. Int J Mol Sci, 2021, 22( 13): 7061. DOI: 10.3390/ijms22137061.
[22]	SHAH PK. Inflammation, infection and atherosclerosis[J]. Trends Cardiovasc Med, 2019, 29( 8): 468- 472. DOI: 10.1016/j.tcm.2019.01.004.
[23]	DURKOVICOVA Z, FAKTOROVA X, JAKABOVICOVA M, et al. Molecular mechanisms in the pathogenesis of metabolically associated fatty liver disease[J]. Bratisl Lek Listy, 2023, 124( 6): 427- 436. DOI: 10.4149/BLL_2023_065.
[24]	KAPIL S, DUSEJA A, SHARMA BK, et al. Small intestinal bacterial overgrowth and toll-like receptor signaling in patients with non-alcoholic fatty liver disease[J]. J Gastroenterol Hepatol, 2016, 31( 1): 213- 221. DOI: 10.1111/jgh.13058.
[25]	YANG LD, DAI YZ, HE H, et al. Integrative analysis of gut microbiota and fecal metabolites in metabolic associated fatty liver disease patients[J]. Front Microbiol, 2022, 13: 969757. DOI: 10.3389/fmicb.2022.969757.
[26]	XU YY, ZHU YD, HU SW, et al. Hepatocyte miR-34a is a key regulator in the development and progression of non-alcoholic fatty liver disease[J]. Mol Metab, 2021, 51: 101244. DOI: 10.1016/j.molmet.2021.101244.
[27]	BADI I, MANCINELLI L, POLIZZOTTO A, et al. MiR-34a promotes vascular smooth muscle cell calcification by downregulating SIRT1(sirtuin 1) and axl(AXL receptor tyrosine kinase)[J]. Arterioscler Thromb Vasc Biol, 2018, 38( 9): 2079- 2090. DOI: 10.1161/ATVBAHA.118.311298.
[28]	GUO YC, ZHOU Y, GAO X, et al. Association between nonalcoholic fatty liver disease and carotid artery disease in a community-based Chinese population: A cross-sectional study[J]. Chin Med J(Engl), 2018, 131( 19): 2269- 2276. DOI: 10.4103/0366-6999.241797.
[29]	TANG CH, GUO L, LI Q, et al. Interpretation on the report of global stroke data 2022[J]. J Diagn Concepts Pract, 2023, 22( 3): 238- 246. DOI: 10.16150/j.1671-2870.2023.03.06. 唐春花, 郭露, 李琼, 等. 2022年全球卒中数据报告解读[J]. 诊断学理论与实践, 2023, 22( 3): 238- 246. DOI: 10.16150/j.1671-2870.2023.03.06.
[30]	HAO WC, LIU YR, ZHANG JH, et al. Detected condition of carotid artery plaque and its risk factors during physical examination[J]. Clin Misdiagn Misther, 2022, 35( 1): 90- 93. DOI: 10.3969/j.issn.1002-3429.2022.01.021. 郝文超, 刘艳如, 张婧环, 等. 健康体检颈动脉斑块检出情况及危险因素分析[J]. 临床误诊误治, 2022, 35( 1): 90- 93. DOI: 10.3969/j.issn.1002-3429.2022.01.021.
[31]	SCHINDLER A, SCHINNER R, ALTAF N, et al. Prediction of stroke risk by detection of hemorrhage in carotid plaques: Meta-analysis of individual patient data[J]. JACC Cardiovasc Imaging, 2020, 13( 2 Pt 1): 395- 406. DOI: 10.1016/j.jcmg.2019.03.028.
[32]	JIANG ZM, CHEN YH, ZHANG ZJ, et al. Influence of metabolic associated fatty liver disease on the degree of carotid stenosis[J]. J Clin Hepatol, 2023, 39( 8): 1874- 1879. DOI: 10.3969/j.issn.1001-5256.2023.08.016. 姜梓萌, 陈宇航, 张志娇, 等. 代谢相关脂肪性肝病对颈动脉狭窄程度的影响[J]. 临床肝胆病杂志, 2023, 39( 8): 1874- 1879. DOI: 10.3969/j.issn.1001-5256.2023.08.016.
[33]	JOSEPHSON SA, BRYANT SO, MAK HK, et al. Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA[J]. Neurology, 2004, 63( 3): 457- 460. DOI: 10.1212/01.wnl.0000135154.53953.2c.
[34]	NETUKA D, BELŠÁN T, BROULÍKOVÁ K, et al. Detection of carotid artery stenosis using histological specimens: A comparison of CT angiography, magnetic resonance angiography, digital subtraction angiography and Doppler ultrasonography[J]. Acta Neurochir(Wien), 2016, 158( 8): 1505- 1514. DOI: 10.1007/s00701-016-2842-0.
[35]	JIAO YG, QIN YH, ZHANG ZG, et al. Early identification of carotid vulnerable plaque in asymptomatic patients[J]. BMC Cardiovasc Disord, 2020, 20( 1): 429. DOI: 10.1186/s12872-020-01709-5.
[36]	WEN W, LI H, WANG C, et al. Metabolic dysfunction-associated fatty liver disease and cardiovascular disease: A meta-analysis[J]. Front Endocrinol(Lausanne), 2022, 13: 934225. DOI: 10.3389/fendo.2022.934225.

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