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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2020

01-12-2020 | Insulins | Original investigation

Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

Authors: Hyeok-Hee Lee, Yongin Cho, Young Ju Choi, Byung Wook Huh, Byung-Wan Lee, Eun Seok Kang, Seok Won Park, Bong-Soo Cha, Eun Jig Lee, Yong-ho Lee, Kap Bum Huh

Published in: Cardiovascular Diabetology | Issue 1/2020

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Abstract

Background

There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.

Methods

From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1–2 years. Ultrasonographic findings at baseline and after 6–8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression.

Results

Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6–8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025–1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005–2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087–5.458; p < 0.05).

Conclusions

Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.
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Metadata
Title
Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study
Authors
Hyeok-Hee Lee
Yongin Cho
Young Ju Choi
Byung Wook Huh
Byung-Wan Lee
Eun Seok Kang
Seok Won Park
Bong-Soo Cha
Eun Jig Lee
Yong-ho Lee
Kap Bum Huh
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2020
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-020-01064-x

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