Author/Authors :
Omar, Nurazam Department of Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Koshy, Marymol Department of Radiology - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Hanafiah, Mohammad Department of Radiology - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Muhammad Hatta, Sharifah Faradilla Wan Department of Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Mohd Shah, Fatimah Zaherah Department of Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Johari, Bushra Department of Radiology - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Johari, Bushra Department of Radiology - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Zamhuri, Idris Department of Population Health and Preventive Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Kasim, Sazzli Shahlan Department of Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Abdul Rahman, Thuhairah Centre for Pathology Diagnostics and Research Laboratories - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia , Abdul Ghani, Rohana Department of Medicine - Faculty of Medicine - Universiti Teknologi MARA - Sungai Buloh Campus - Jalan Hospital, Sungai Buloh, Selangor, Malaysia
Abstract :
Background: Nonalcoholic fatty liver disease (NAFLD) has become one of the major diseases plaguing worldwide. Several studies
reported its association with ischemic heart disease (IHD). This study aims to determine the relationships between severity of steatosis
with glycemic control and carotid intima‑media thickness (CIMT) among a high‑risk population of type 2 diabetes mellitus (T2DM)
with proven IHD. Materials and Methods: This was a cross‑sectional study involving patients aged between 18 and 65 years diagnosed
with T2DM with IHD (n = 150). Ultrasonography of the abdomen to determine NAFLD severity category and CIMT measurements
was performed by two independent radiologists. NAFLD was graded according to the severity of steatosis (NAFLD‑3, NAFLD‑2,
NAFLD‑1, and NAFLD‑0). Comparison between different stages of NAFLD (NAFLD‑3, NAFLD‑2, NAFLD‑1, and NAFLD‑0) was
analyzed using Chi‑square and analysis of variance tests for categorical and continuous variables, respectively. Results: The prevalence
of NAFLD was 71% (n = 107). NAFLD‑1 was detected in 39% of the patients, 32% had NAFLD‑2, no patients with NAFLD‑3, and
29% had non‑NAFLD. There were no patients with NAFLD‑2 having higher systolic and diastolic blood pressure, weight, body
mass index, waist circumference, total cholesterol, triglycerides, high‑density lipoprotein cholesterol, and low‑density lipoprotein
cholesterol. Glycated hemoglobin (HbA1c) concentration was highest within the NAFLD‑2. NAFLD‑2 showed higher mean CIMT.
Every 1% rise in HbA1c for patients with NAFLD significantly increases the CIMT by 0.03 mm (95% CI: 0.009, 0.052, P = 0.006).
Conclusion: These findings suggest additional atherosclerotic risks within the NAFLD‑2 group with significantly higher HbA1c and
CIMT compared to the NAFLD‑1 and NAFLD‑0 groups. It is, therefore, vital to incorporate stricter glycemic control among patients
with T2DM and IHD with moderate NAFLD as part of atherosclerotic risk management strategy.
