Association between nonalcoholic fatty liver disease and carotid atherosclerosis: a meta-analysis

Objective: We carried out a meta-analysis about non-alcoholic fatty liver disease, carotid artery intima-media thickness and carotid artery plaque to explore the association between nonalcoholic fatty liver disease (NAFLD) and carotid atherosclerosis. Methods: We searched for case-control studies about the relationship between NAFLD and carotid intima-media thick (IMT) published from 2004 to 2014 according to inclusion and exclusion criteria and extracted the relevant data. Statistical analysis was processed by RevMan 5.2 software. Results: 9 studies were involved totally, including 2446 subjects (925 patients and 1521 controls). We found that there was a significant heterogeneity between NAFLD and carotid IMT. By the random effects model we calculated and combined the mean value of carotid IMT. The mean difference was 0.16 mm with 95% confidence interval (0.11, 0.21). Studies showed that there was also heterogeneity between carotid artery plaque and NAFLD. By the random effects model the calculated and combined OR value was 3.73 with 95% confidence interval (2.42, 5.74). The publication bias of the included studies did not exist. Conclusion: The IMT in NAFLD patients increased 0.16 mm compared with the control group, and risk of carotid plaque was 3.73 times than that of the controls. It is necessary for NAFLD patients to carry out routine carotid ultrasound detection to predict the occurrence of carotid atherosclerosis and assess the risk of cardiovascular disease.