Carotid intima media as predictor of liver fibrosis in type 2 diabetes mellitus with NAFLD

Bharmal Vahid Shabbirhussain; Saurabh Singh; Vinod Kumar Dixit; Ashish Verma; Surya Kumar Singh

doi:10.1016/j.dsx.2022.102560

Carotid intima media as predictor of liver fibrosis in type 2 diabetes mellitus with NAFLD

Diabetes Metab Syndr. 2022 Jul;16(7):102560. doi: 10.1016/j.dsx.2022.102560. Epub 2022 Jul 1.

Authors

Bharmal Vahid Shabbirhussain¹, Saurabh Singh², Vinod Kumar Dixit³, Ashish Verma⁴, Surya Kumar Singh⁵

Affiliations

¹ Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
² Department of Gastroenterology, Himalayan Medical College, Jolly Grant, Deharadun, 248140, India.
³ Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
⁴ Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
⁵ Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. Electronic address: surya@bhu.ac.in.

PMID: 35816948
DOI: 10.1016/j.dsx.2022.102560

Abstract

Background and aims: Non Alcoholic Fatty Liver Disease (NAFLD) is common in type 2 Diabetes Mellitus (DM) that might progress to advance liver fibrosis. Early recognition of liver fibrosis may have clinical implication. Non invasive assessment tool for severity of liver fibrosis in NAFLD is expensive fibroscan. An alternate method of diagnosis will be very useful innovation. We aimed to evaluate Carotid Intima Media Thickness (CIMT) and its association with severity of liver fibrosis in patients with type 2 DM and NAFLD.

Methods: Treatment naïve patients with type 2 DM were enrolled. Measurement of CIMT, hepatic ultrasound and fibroscan were done. Liver function tests included hepatic transaminases. The data obtained was subjected to statistical analysis using IBM SPSS version 20.0 software.

Result: Prevalence of NAFLD was 76% including 12% with moderate to advance liver fibrosis in patients with type 2 DM. CIMT was significantly higher in patients with NAFLD than with normal liver. CIMT positively correlated with severity of liver fibrosis measured by fibroscan. ROC curve analysis showed right CIMT value of 0.575 mm predicting liver fibrosis with sensitivity of 91.7% and specificity of 78.9%.

Conclusion: Three fourth of patients with type 2 DM had NAFLD but small proportion had moderate to advance liver fibrosis. CIMT increased more in patients with NAFLD than with normal liver in T2DM. CIMT value of 0.575 mm has a good sensitivity to predict liver fibrosis and therefore, it can be a reliable marker of severity of Non Alcoholic Steato Hepatitis (NASH) in diabetes with NAFLD.

Keywords: Carotid intima media thickness; Fibroscan; Non alcoholic fatty liver disease; Type 2 diabetes mellitus.

MeSH terms

Carotid Arteries / diagnostic imaging
Carotid Intima-Media Thickness
Diabetes Mellitus, Type 2* / complications
Humans
Liver Cirrhosis / diagnosis
Liver Cirrhosis / etiology
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / diagnosis
Non-alcoholic Fatty Liver Disease* / epidemiology
Risk Factors