The association between metabolic dysfunction-associated steatotic liver disease, cardiovascular and cerebrovascular diseases and the thickness of carotid plaque

Yunqian Huang; Yuqun Wang; Zhengguang Xiao; Shengqi Yao; Yuhua Tang; Linjun Zhou; Qin Wang; Yanchun Xie; Lixia Zhang; Yan Zhou; Ying Lu; Wenqian Zhu; Man Chen

doi:10.1186/s12872-023-03580-6

The association between metabolic dysfunction-associated steatotic liver disease, cardiovascular and cerebrovascular diseases and the thickness of carotid plaque

BMC Cardiovasc Disord. 2023 Nov 11;23(1):554. doi: 10.1186/s12872-023-03580-6.

Authors

Yunqian Huang^#¹, Yuqun Wang^#¹, Zhengguang Xiao², Shengqi Yao³, Yuhua Tang¹, Linjun Zhou¹, Qin Wang¹, Yanchun Xie¹, Lixia Zhang¹, Yan Zhou¹, Ying Lu¹, Wenqian Zhu¹, Man Chen⁴

Affiliations

¹ Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. maggiech1221@126.com.

^# Contributed equally.

Abstract

Background: The relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerosis has been controversial, which has become a hit of recent research. The study aimed to explore the association between MASLD, cardiovascular and cerebrovascular diseases (CCVD), and the thickness of carotid plaque which was assessed by ultrasound.

Methods: From September 2018 to June 2019, 3543 patients were enrolled. We asked participants to complete questionnaires to obtain information. All patients underwent liver ultrasound and bilateral carotid ultrasound to obtain carotid intima-media thickness (IMT) and maximum carotid plaque thickness (CPT). Hepatic steatosis was quantified during examination according to Hamaguchi's ultrasonographic score, from 0 to 6 points. A score < 2 was defined as without fatty liver, and a score ≥ 2 was defined as fatty liver. Information about blood lipids was collected based on the medical records.

Results: We found common risk factors for CCVD events, MASLD, and atherosclerosis. There was a significant correlation between MASLD and carotid plaque, but not with CPT. No association was found between MASLD and CCVD events. CPT and IMT were thicker in CCVD patients than in non-CCVD patients. No significant difference was found between IMT and CPT in MASLD patients and non-MASLD patients. CCVD was independently and consistently associated with higher IMT, and free fatty acid (FFA).

Conclusions: According to our results, we recommend carotid ultrasound examination of the patients when FFA is increased, regardless of the presence of risk factors and MASLD. Due to the distribution of CPT of both CCVD and MASLD patients in the CPT 2-4 mm group, contrast-enhanced ultrasound is necessary to assess the vulnerability of the plaque when CPT ≥ 2 mm. Timely treatment of vulnerable plaques may reduce the incidence of future CCVD events.

Keywords: Cardiovascular disease; Carotid plaque; Cerebrovascular disease; Free fatty acid; Metabolic dysfunction-associated steatotic liver disease; Ultrasound.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Atherosclerosis*
Cardiovascular Diseases* / epidemiology
Carotid Artery Diseases* / diagnostic imaging
Carotid Artery Diseases* / etiology
Carotid Intima-Media Thickness
Cerebrovascular Disorders* / diagnostic imaging
Cerebrovascular Disorders* / etiology
Fatty Liver* / complications
Humans
Plaque, Atherosclerotic* / complications
Risk Factors

Associated data

ChiCTR/ChiCTR2000040163