Association Between Nonalcoholic Fatty Liver Disease And Carotid Atherosclerosis:a Meta-Analysis

Background/Aims:Carotid atherosclerosis is one of the important independent risk factors of coronary heart disease. In this paper, we did a meta-analysis to explore the association between nonalcoholic fatty liver disease (NAFLD) and carotid atherosclerosis.Method:We searched for the population-based case-control studies about the relation between adult non-alcoholic fatty liver disease and carotid intima-media thickness (IMT) published from2004to2012, in which information on number of subjects in controls and patients, and data to evaluate carotid IMT and carotid plaques (measured by carotid ultrasound) could be extracted. Statistical analysis was processed by using Review Manager5.0and STATA11.0software.Results:7studies were involved totally, including1168subjects (504patients and664controls). We found a significant association between NAFLD and carotid IMT in random models (Mean Differences:0.18,95%CI:0.12-0.25, p<0.00001), but also a significant heterogeneity existed (I2=94%). Meta-regression analysis showed that mean differences in gamma-glutamyl transpeptidase were strongly correlated with those in IMT (p=0.017). In addition,5reports including934subjects (380patients and554controls) showed that carotid plaques were more frequently observed in NAFLD patients in comparison with controls, fixed model (OR:3.51,95%CI:2.53-4.86, p<0.00001), and no heterogeneity (I2=0%).Conclusion:NAFLD patients had IMT generally increased0.18mm and3.51times risk of carotid plaque than controls. It is necessary that routine carotid ultrasonography measurement processed in NAFLD patients, to predict the occurrence of carotid atherosclerosis and to assess the risk of cardiovascular disease.