Nonalcoholic Fatty Liver Disease Is Associated With Increased Carotid Intima-Media Thickness Only in Type 2 Diabetic Subjects With Insulin Resistance

Kim, Kyung Soo; Choi, Young Ju; Huh, Byung Wook; Park, Seok Won; Lee, Mi Kyung; Cho, Yong Wook; Huh, Kap Bum

doi:10.1210/jc.2013-4133

Cited by 47 publications

(47 citation statements)

References 15 publications

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“…Among diet-controlled T2DM individuals the significant increase of cIMT in the presence of NAFLD is largely explained by HOMA-estimated IR [18]. Recently, Kim et al concluded that NAFLD not accompanied by insulin resistence is not associated with a carotid atherosclerotic burden [19]. We could not demonstrate a correlation between cIMT and HOMA-IR in our T2DM patients.…”

Section: Discussioncontrasting

confidence: 70%

“…Many works showed no association between the degree of liver steatosis and early atherosclerosis as measured by US [14][15][16] or computed tomography [17] in T2DM patients. In contrast, other studies in T2DM subjects indicated a significant increase of cIMT in the presence of NAFLD that could be partially explained by the presence of insulin resistance [18,19]. Body fat distribution seems to play an important role in atherosclerosis progression in non-diabetic patients with NAFLD but in T2DM subjects this aspect is not completely known.…”

Section: Introductionmentioning

confidence: 79%

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Age, abdominal obesity, and glycated hemoglobin are associated with carotid atherosclerosis in type 2 diabetes patients with nonalcoholic fatty liver disease

Silaghi

Crăciun

et al. 2015

Med Ultrason

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Aim: The aim of this study was to evaluate the impact of clinical parameters and indices of body composition on the relation between non-alcoholic fatty liver disease (NAFLD) and carotid intima-media thickness (cIMT), in a type 2 diabetes mellitus population (T2DM). Material and methods: We retrospectively enrolled 336 T2DM outpatients who regularly attended Regina Maria Clinic in Cluj. Clinical, anthropometric and biochemical parameters were measured. Ultrasonography (US) was used to assess hepatic steatosis (HS) in all patients and cIMT in 146 subjects. Body composition was assessed by bioelectric impedance (BIA, InBody 720) in all patients. Results: cIMT was correlated with age (r=0.25; p=0.004), systolic blood pressure (r=0.18; p=0.041), glycated haemoglobin A1C (HbA1C, r=0.20; p=0.04), and with coronary artery disease (r=0.20; p=0.007). HS did not correlate with cIMT (r=0.04; p=0.64). cIMT was correlated with visceral fatty area (VFA, r=0.18; p=0.014) but not with other indices of body composition. Homeostasis model assessment for insulin resistance (HOMA-IR) was not correlated with cIMT (r=0.17; p=0.086). After multivariate analysis, age, HbA1c, and VFA were good independent predictors of cIMT (r=0.45; p˂0.001). Conclusions: These results are suggestive that in T2DM patients, fatty liver is not a direct mediator of early carotid atherosclerosis. Our data indicate that visceral fat accumulation and HbA1C are determinant factors of cIMT sugesting that controlling abdominal obesity and hyperglicemia might reduce atherosclerotic disease risk in NAFLD-T2DM subjects.

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Section: Discussioncontrasting

confidence: 70%

Section: Introductionmentioning

confidence: 79%

Age, abdominal obesity, and glycated hemoglobin are associated with carotid atherosclerosis in type 2 diabetes patients with nonalcoholic fatty liver disease

Silaghi

Crăciun

et al. 2015

Med Ultrason

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“…Additionally, antioxidative markers may be inversely associated with TG levels in early preclinical atherosclerosis even with normal levels of plasma cholesterol [34], and our group has previously demonstrated that liraglutide is able to reduce markers of oxidative stress in patients with T2DM [35]. Kim SK et al [36] have interestingly reported that nonalcoholic fatty liver disease (NAFLD) is very common in subjects with T2DM, but NAFLD not accompanied by insulin resistance is not associated with a carotid atherosclerotic burden. However, in this latter study [36], coexistence of NAFLD and insulin resistance seemed to be an independent predictor of increased cIMT.…”

Section: Discussionmentioning

confidence: 99%

“…Kim SK et al [36] have interestingly reported that nonalcoholic fatty liver disease (NAFLD) is very common in subjects with T2DM, but NAFLD not accompanied by insulin resistance is not associated with a carotid atherosclerotic burden. However, in this latter study [36], coexistence of NAFLD and insulin resistance seemed to be an independent predictor of increased cIMT. Therefore, a greater cIMT reduction in subjects with NAFLD and insulin resistance in our study remains a strong possibility.…”

Section: Discussionmentioning

confidence: 99%

Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospective study

Rizzo

Rizvi

Patti

et al. 2016

Cardiovasc Diabetol

113

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BackgroundLiraglutide, a GLP-1 analogue, exerts several beneficial non-glycemic effects in patients with type-2 diabetes (T2DM), such as those on body weight, blood pressure, plasma lipids and inflammation markers. However, the effects of liraglutide on cardiovascular (CV) risk markers in subjects with the metabolic syndrome (MetS) are still largely unknown. We herein explored its effects on various cardio-metabolic risk markers of the MetS in subjects with T2DM.MethodsWe performed an 18-month prospective, real-world study. All subjects had T2DM and the MetS based on the AHA/NHLBI criteria. Subjects with a history of a major CV event were excluded. One hundred-twenty-one subjects (71 men and 50 women; mean age: 62 ± 9 years) with T2DM and the MetS, who were naïve to incretin-based therapies and treated with metformin only, were included. Liraglutide (1.2 mg/day) was added to metformin (1500–3000 mg/day) for the entire study. Fasting plasma samples for metabolic parameters were collected and carotid-intima media thickness (cIMT) was assessed by B-mode real-time ultrasound at baseline and every 6 months thereafter.ResultsThere was a significant reduction in waist circumference, body mass index, fasting glycemia, HbA1c, total- and LDL-cholesterol, triglycerides, and cIMT during the 18-month follow-up. Correlation analysis showed a significant association between changes in cIMT and triglycerides (r = 0.362; p < 0.0001). The MetS prevalence significantly reduced during the study, and the 26% of subjects no longer fulfilled the criteria for the MetS after 18 months.ConclusionsLiraglutide improves cardio-metabolic risk factors in subjects with the MetS in a real-world study. Trial Registration ClinicalTrials.gov: NCT01715428.

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“…reported that NAFLD was associated with elevated CIMT, independent of conventional CVD risk factors. On the contrary, NAFLD not accompanied by insulin resistance was not associated with increased CIMT in a recent study including patients with type 2 diabetes . In a small study including 40 Asian Indians with NAFLD and 40 healthy controls, NAFLD was found to be significantly associated with increased CIMT independent of obesity and metabolic syndrome .…”

Section: Discussionmentioning

confidence: 74%

The synergistic impact of nonalcoholic fatty liver disease and metabolic syndrome on subclinical atherosclerosis

Hong

Hwang

Ryu

et al. 2015

Clinical Endocrinology

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Nonalcoholic Fatty Liver Disease Is Associated With Increased Carotid Intima-Media Thickness Only in Type 2 Diabetic Subjects With Insulin Resistance

Abstract: NAFLD is very common in subjects with type 2 diabetes, but NAFLD not accompanied by insulin resistance is not associated with a carotid atherosclerotic burden. However, having both NAFLD and insulin resistance seemed to be an independent predictor of increased C-IMT.

Cited by 47 publications

References 15 publications

Age, abdominal obesity, and glycated hemoglobin are associated with carotid atherosclerosis in type 2 diabetes patients with nonalcoholic fatty liver disease

Age, abdominal obesity, and glycated hemoglobin are associated with carotid atherosclerosis in type 2 diabetes patients with nonalcoholic fatty liver disease

Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospective study

The synergistic impact of nonalcoholic fatty liver disease and metabolic syndrome on subclinical atherosclerosis

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