Ultrasound Diagnosis of Hepatic Steatosis as a Surrogate for Atherosclerosis

Abstract

Introduction:

Ultrasonography has become available to most physicians in primary care. Increasingly hepatic steatosis becomes a chance finding, which has been shown to be associated with cardiovascular risk factors, surrogates of vascular disease, and vascular events. This study tries to answer the question whether it is justified to recommend a cardiovascular workup in response to the incidental finding of hepatic steatosis in asymptomatic healthy individuals.

Methods:

The data of 259 healthy women and 561 men aged 19–93 years, who consecutively underwent a primary preventive check-up, were retrospectively analyzed. Ultrasonography for diagnosis of hepatic steatosis, determination of the maximal intima media thickness (IMT) and plaques of the carotid arteries was performed by a single certified physician according to conventional criteria.

Results:

Hepatic steatosis was found in 28.3% men and 7.7% women. In 88% the steatosis was judged to be mild. These individuals differed from those without hepatic steatosis in body mass index, ALAT, GGT, HbA1c, fasting glucose, triglycerides, HDL and lipoprotein(a). The IMT was higher and plaques were more prevalent. In logistic regression analysis hepatic steatosis was a highly significant predictor of the presence of an IMT>0.8 mm or carotid plaques besides age and sex. This was also the case in analyses including BMI, or multiple risk factors, which added only lipoprotein(a) as a predictor.

Conclusion:

The incidental diagnosis of hepatic steatosis is a strong indicator for the presence of cardiovascular risk factors and even signs of developing atherosclerosis. Thus, the recommendation of further cardiovascular workups seems appropriate.

Keywords

ultrasound 2D - arteriosclerosis - health policy and practice

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