NAFLD, insulin resistance associated with increased carotid intima-media thickness

Kim S-K. J Clin Endocrinol Metab. 2014; doi: 10.1210/jc.2013-4133.

  • February 13, 2014

In patients with type 2 diabetes, the prevalence of non-alcoholic fatty liver disease, or NAFLD, accompanied by insulin resistance appeared to be an independent predictor of increased carotid intima-media thickness, according to data.

“Thus, the identification of both NAFLD and insulin resistance in subjects with type 2 diabetes may be useful for CVD risk stratification,” Soo-Kyung Kim, MD, of CHA Bundang Medical Center and CHA University in Seongnam, Korea, and colleagues wrote.

The observational study included 3,226 consecutively enrolled patients with type 2 diabetes, measured for hepatic steatosis and mean carotid intima-media thickness (C-IMT).

They observed 72.7% prevalence of NAFLD; of those, 747 (23.2%) were not insulin resistance, researchers wrote.

However, there were significant differences in C-IMT and frequency of carotid atherosclerosis between groups classified by insulin resistance within the same NAFLD strata, the researchers wrote.

Specifically, C-IMT was greatest among patients with both NAFLD and insulin resistance (0.844 mm vs. 0.786), in insulin-sensitive patients without NAFLD (0.821 mm), insulin-resistant patients without NAFLD (0.807 mm), and insulin-sensitive patients with NAFLD (P for trend<.001), according to data.

“In addition, the relationship between NAFLD and/or insulin resistance and the frequency of carotid atherosclerosis disappeared after adjusting for potential confounders,” researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

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