الفهرس 
NON-ALCOHOLIC FATTY LIVEROnly 14 pages are availabe for public view
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Abstract
on-alcoholic fatty liver disease (NAFLD) is the most
common cause of liver disease worldwide, with a
prevalence of 15%-30% in Western populations. Non-alcoholic
fatty liver disease (NAFLD) has emerged as the most important
cause of chronic liver disease related to the increase in
incidence of obesity and diabetes mellitus type II in the
population.
The spectrum of NAFLD ranges from fatty liver alone to
steatohepatitis, and may progress to end-stage liver disease.
NAFLD is strongly associated with obesity, type II diabetes,
and dyslipidaemia.
Thus, NAFLD shares many features of the metabolic
syndrome (MetS), a highly atherogenic condition, and its
presence could signify a substantial cardiovascular risk above
and beyond that conferred by individual risk factors.
The possible relationship between hepatic steatosis and
carotid lesions might have important practical consequences,
considering the frequent incidental finding of bright hepatomegaly
in subjects undergoing abdominal ultrasound for any reason or
hepatic steatosis by liver biopsy. In these subjects, an ultrasound
assessment of carotid arteries might also be advisable.
This study was designed to assess the correlation between
NAFLD as a cardiovascular risk factor and carotid atherosclerosis.It was conducted in in Internal Medicine and Hepatology inpatient
and outpatient ward, Faculty of Medicine, Ain Shams University,
in the period from Mar 2015 to Seb 2015.
The current study included 60 patients who fulfilled the
pre-designed inclusion criteria which were adult patients >
37years and less than 59 years old with clinical, biochemical
and ultra-sonographic criteria NAFLD.
All the studied cases were subjected to the following; full
history taking, thorough clinical examination, laboratory
investigations, complete blood picture. Liver profile tests including
[ALT, AST, total and direct bilirubin, serum albumin, prothrombin
time and international randomization ratio (INR)]. Hepatitis markers
(HCV Abs and HBV sAg). Lipid profile (serum cholesterol, LDL,
HDL, and serum triglyceride). Glucose profile (fasting blood sugar,
HbAlc). Abdominal ultrasound, carotid ultrasonography were also
done. Liver biopsywas done only for group 1 and 2.
There was female predominance being 38 (63.33%)
female patients and 22 (36.67%) male patient. Their age ranged
between 37 and 59 years.
Our study revealed a significant increase in carotid IMT in
diabetic patients with NAFLD (0.695 ± 0.226mm) than non
diabetic patients with fatty liver (0.655±0.216mm) after controlling
of confounding factors, the differences between two groups of diabetics and non diabetics with fatty liver were not statistically
significant (P value <0.792).
CIMT in the healthy group was significantly and
independently less than two other groups.
This means that the patients with NAFLD may be at risk of
early Atherosclerosis and independent to metabolic syndrome. We
found a strong association between the increase of liver enzymes
level and increase of carotid IMT in patients of NAFLD which
was highly significant (P value <0.001). So it is important to
consider not only degree of fatty infiltration in abdominal
ultrasound but also at the laboratory level regarding liver
enzymes.
This study shows that the grade of NAFLD has a great
effect on severity of atherosclerosis. In conclusion, our findings
support the hypothesis that the presence of NAFLD is strongly
associated with early carotid atherosclerosis.