Association between carotid intima media thickness and retinal arteriovenous ratio in non-alcoholic fatty liver disease

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is the metabolic syndrome of liver with high risk in developing cardiovascular diseases. Retinal vessels and carotid artery provide early evidence of vascular ill health. In NAFLD by estimating CIMT (carotid intima media thickness) and retinal a-v (arterio venous) ratio the proneness to cardiovascular diseases can be assessed before its development. Objective of the study was to find out an association between CIMT and retinal a-v ratio in NAFLD
Methods: A cross sectional study was done at a tertiary centre in Karnataka. Sample size was 90. Patients with NAFLD of 18-60 yrs were included. After taking consent, clinical examination, liver function test, NAFLD grading, CIMT and retinal a-v ratio calculations were done.
Results: In this study 3/4th had Grade 1 NAFLD and remaining Grade II. Significant associations were found between NAFLD and diabetes, hypertension & their durations. 51.5% with diabetes, 77.8% with HTN and 61.3% with dyslipidemia had increased CIMT. Significant associations were found between a-v ratio and dyslipidemia, hypertension and its duration. Around 91.3% with NAFLD grade 2 had reduced AV ratio compared to 49.3% with NAFLD 1. Patients who had increased CIMT had narrow retinal AV ratio, which was true for both grades.

Conclusion: NAFLD had higher prevalence of increased CIMT and decreased retinal a-v ratio. High CIMT is always associated with small retinal a-v ratio in all grades. Decreased retinal a-v ratio is more prevalent, hence a better predictor of cardiovascular risk in NAFLD