The association between metabolic dysfunction-associated steatotic liver disease, cardiovascular and cerebrovascular diseases and the thickness of carotid plaque
Open accessAbstract
BACKGROUND: The relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerosis has been controversial, which has become a hit of recent research. The study aimed to explore the association between MASLD, cardiovascular and cerebrovascular diseases (CCVD), and the thickness of carotid plaque which was assessed by ultrasound. METHODS: From September 2018 to June 2019, 3543 patients were enrolled. We asked participants to complete questionnaires to obtain information. All patients underwent liver ultrasound and bilateral carotid ultrasound to obtain carotid intima-media thickness (IMT) and maximum carotid plaque thickness (CPT). Hepatic steatosis was quantified during examination according to Hamaguchi's ultrasonographic score, from 0 to 6 points. A score < 2 was defined as without fatty liver, and a score ≥ 2 was defined as fatty liver. Information about blood lipids was collected based on the medical records. RESULTS: We found common risk factors for CCVD events, MASLD, and atherosclerosis. There was a significant correlation between MASLD and carotid plaque, but not with CPT. No association was found between MASLD and CCVD events. CPT and IMT were thicker in CCVD patients than in non-CCVD patients. No significant difference was found between IMT and CPT in MASLD patients and non-MASLD patients. CCVD was independently and consistently associated with higher IMT, and free fatty acid (FFA). CONCLUSIONS: According to our results, we recommend carotid ultrasound examination of the patients when FFA is increased, regardless of the presence of risk factors and MASLD. Due to the distribution of CPT of both CCVD and MASLD patients in the CPT 2-4 mm group, contrast-enhanced ultrasound is necessary to assess the vulnerability of the plaque when CPT ≥ 2 mm. Timely treatment of vulnerable plaques may reduce the incidence of future CCVD events.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cardiovascular disease is consistently and independently associated with circulating non-esterified fatty acid concentrations and higher intima media thickness, warranting carotid ultrasound examination in adults with increased non-esterified fatty acids and contrast-enhanced ultrasound to assess plaque vulnerability.
“Cardiovascular disease is consistently and independently associated with circulating non-esteri fi ed fatty acid concentrations and higher intima media thickness, warranting carotid ultrasound examination in adults with increased non-esteri fi ed fatty acids 228 and contrast-enhanced ultrasound to assess plaque vulnerability.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [228]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(2004) · The Lancet · doi:10.1016/s0140-6736(03)15268-3 · Cited by 12,717 · see citing works
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60460-8 · Cited by 11,952 · see citing works
Mancia, G., Fagard, R., Narkiewicz, K., Redón, J., Zanchetti, A., Böhm, M., Christiaens, T., Cifkova, R., De Backer, G., Dominiczak, A., et al. (2013) · Journal of Hypertension · doi:10.1097/01.hjh.0000431740.32696.cc · Cited by 5,655 · see citing works
Mechanisms of NAFLD development and therapeutic strategies
Friedman, S. L., Neuschwander-Tetri, B. A., Rinella, M., & Sanyal, A. J. (2018) · Nature Medicine · doi:10.1038/s41591-018-0104-9 · Cited by 4,354 · see citing works
Nishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Fleisher, L. A., Jneid, H. M., Mack, M. J., McLeod, C. J., O’Gara, P. T., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.011 · Cited by 3,360 · see citing works
Evolution of inflammation in nonalcoholic fatty liver disease: The multiple parallel hits hypothesis
Tilg, H., & Moschen, A. R. (2010) · Hepatology · doi:10.1002/hep.24001 · Cited by 2,548 · see citing works
Nishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Fleisher, L. A., Jneid, H. M., Mack, M. J., McLeod, C. J., O’Gara, P. T., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000503 · Cited by 2,506 · see citing works
Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease
Targher, G., Day, C. P., & Bonora, E. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0912063 · Cited by 1,907 · see citing works
Hernaez, R., Lazo, M., Bonekamp, S., Kamel, I., Brancati, F. L., Guallar, E., & Clark, J. M. (2011) · Hepatology · doi:10.1002/hep.24452 · Cited by 1,585 · see citing works
Zhou, M., Wang, H., Zhu, J. W., Chen, W., Wang, L., Liu, S., Yichong, L., Wang, L., Liu, Y., Yin, P., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00551-6 · Cited by 1,466 · see citing works
Ye, Q., Zou, B., Yeo, Y. H., Li, J., Huang, D. Q., Wu, Y., Yang, H., Liu, C., Kam, L. Y., Tan, X. X. E., et al. (2020) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(20)30077-7 · Cited by 925 · see citing works
Hamaguchi, M., Kojima, T., Itoh, Y., Harano, Y., Fujii, K., Nakajima, T., Kato, T., Takeda, N., Okuda, J., Ida, K., et al. (2007) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2007.01526.x · Cited by 908 · see citing works
Wang, L., Zhou, B., Zhao, Z., Yang, L., Zhang, M., Jiang, Y., Li, Y., Zhou, M., Wang, L., Huang, Z., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00798-4 · Cited by 585 · see citing works
The Subtle Balance between Lipolysis and Lipogenesis: A Critical Point in Metabolic Homeostasis
Saponaro, C., Gaggini, M., Carli, F., & Gastaldelli, A. (2015) · Nutrients · doi:10.3390/nu7115475 · Cited by 531 · see citing works
Farrell, G. C., Chitturi, S., Lau, G. K. K., Sollano, J. D., & NAFLD, F. T. A. W. P. O. (2007) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2007.05002.x · Cited by 518 · see citing works
A Modern Approach to Dyslipidemia
Berberich, A. J., & Hegele, R. A. (2021) · Endocrine Reviews · doi:10.1210/endrev/bnab037 · Cited by 503 · see citing works
Nonalcoholic Fatty Liver Disease and the Heart
Stahl, E. P., Dhindsa, D. S., Lee, S. K., Sandesara, P. B., Chalasani, N., & Sperling, L. S. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.050 · Cited by 445 · see citing works
Reply: A multi-society Delphi consensus statement on new fatty liver disease nomenclature
Lazarus, J. V., Newsome, P. N., Francque, S. M., Kanwal, F., Terrault, N. A., & Rinella, M. E. (2024) · Hepatology · doi:10.1097/hep.0000000000000696 · Cited by 438 · see citing works
Gastaldelli, A., Kozàkovà, M., Højlund, K., Flyvbjerg, A., Favuzzi, A. M. R., Mitrakou, A., & Balkau, B. (2009) · Hepatology · doi:10.1002/hep.22845 · Cited by 373 · see citing works
Oni, E., Agatston, A. S., Blaha, M. J., Fialkow, J. A., Cury, R. C., Sposito, A. C., Erbel, R., Blankstein, R., Feldman, T., Al-Mallah, M. H., et al. (2013) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2013.07.052 · Cited by 352 · see citing works
Muzurović, E. M., Mikhailidis, D. P., & Mantzoros, C. S. (2021) · Metabolism · doi:10.1016/j.metabol.2021.154770 · Cited by 339 · see citing works
Fatty acid regulation of hepatic lipid metabolism
Jump, D. Β. (2010) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e328342991c · Cited by 272 · see citing works
Sillesen, H., Sartori, S., Sandholt, B., Baber, U., Mehran, R., & Fuster, V. (2018) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jex239 · Cited by 204 · see citing works
Luukkonen, P. K., Qadri, S., Ahlholm, N., Porthan, K., Männistö, V., Sammalkorpi, H., Penttilä, A. K., Hakkarainen, A., Lehtimäki, T. E., Gaggini, M., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.10.013 · Cited by 170 · see citing works
Sinn, D. H., Kang, D., Chang, Y., Ryu, S., Gu, S., Kim, H., Seong, D., Cho, S. J., Yi, B.-K., Park, H., et al. (2016) · Gut · doi:10.1136/gutjnl-2016-311854 · Cited by 164 · see citing works
Lee, S. B., Park, G., Lee, J., Lee, B. U., Park, J. H., Kim, B. G., Jung, S. W., Jeong, I. D., Bang, S. J., Shin, J. W., et al. (2017) · Journal of Hepatology · doi:10.1016/j.jhep.2017.12.012 · Cited by 155 · see citing works
Muzurović, E., Peng, C. C., Belanger, M. J., Sanoudou, D., Mikhailidis, D. P., & Mantzoros, C. S. (2022) · Hypertension · doi:10.1161/hypertensionaha.122.17982 · Cited by 138 · see citing works
Han, E., Lee, Y., Kim, Y. D., Kim, B. K., Park, J. Y., Kim, D. Y., Ahn, S. H., Lee, B., Kang, E. S., Soo, B., et al. (2020) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000572 · Cited by 109 · see citing works
Meyersohn, N. M., Mayrhofer, T., Corey, K. E., Bittner, D. O., Staziaki, P. V., Szilveszter, B., Hallett, T. R., Lu, M. T., Puchner, S. B., Simon, T. G., et al. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.07.030 · Cited by 107 · see citing works
Mitchell, C., Korcarz, C. E., Gepner, A. D., Kaufman, J. D., Post, W. S., Tracy, R. P., Gassett, A. J., Ma, N., McClelland, R. L., & Stein, J. H. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.06.005 · Cited by 79 · see citing works
Xu, L., Lu, W., Li, P., Shen, F., Mi, Y., & Fan, J. (2017) · Digestive and Liver Disease · doi:10.1016/j.dld.2017.03.013 · Cited by 73 · see citing works
Pais, R., Redheuil, A. B., Cluzel, P., Ratziu, V., & Giral, P. (2018) · Hepatology · doi:10.1002/hep.30223 · Cited by 69 · see citing works
Mathiesen, E. B., & Johnsen, S. H. (2009) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2009.01210.x · Cited by 55 · see citing works
Li, X., Xia, M., Ma, H., Albert Hofman, D., Hu, Y., Yan, H., He, W., Lin, H., Jeekel, J. J., Zhao, N., et al. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.07.002 · Cited by 45 · see citing works
Association between nonalcoholic fatty liver disease and carotid atherosclerosis: a meta-analysis.
Cai, J. X., Zhang, S., & Huang, W. (2015) · Europe PMC (PubMed Central) · Cited by 37 · see citing works
Liver disease: an overlooked complication of diabetes mellitus
Arrese, M. A. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2010.173 · Cited by 34 · see citing works
Hsu, P., Wang, Y., Lin, C., Wang, Y., Ding, Y.-Z., Liou, T., Huang, S., Lu, T., Chan, W., Lin, S., et al. (2020) · Liver International · doi:10.1111/liv.14637 · Cited by 34 · see citing works
Valenzuela‐Vallejo, L., & Mantzoros, C. S. (2022) · Metabolism · doi:10.1016/j.metabol.2022.155246 · Cited by 32 · see citing works
Zhang, Y., Bai, L., Shi, M., Lu, H., Wu, Y., Tu, J., Ni, J., Wang, J., Cao, L., Lei, P., et al. (2017) · Oncotarget · doi:10.18632/oncotarget.15415 · Cited by 30 · see citing works
Perticone, M., Cimellaro, A., Maio, R., Caroleo, B., Sciacqua, A., Sesti, G., & Perticone, F. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17040456 · Cited by 26 · see citing works
Waard, D. D. D., Morris, D., de Borst, G. J., Bulbulia, R. A., & Halliday, A. W. (2017) · The Journal of Cardiovascular Surgery · doi:10.23736/s0021-9509.16.09770-6 · Cited by 25 · see citing works
Wang, C., Lv, G.-P., & Zang, D. (2017) · Brain and Behavior · doi:10.1002/brb3.847 · Cited by 25 · see citing works
Non-alcoholic Fatty Liver Disease in Children
Muzurović, E. M., Pοlyzos, S. A., Mikhailidis, D. P., Borozan, S., Novosel, D., Cmiljanić, O., Kadić, N., & Mantzoros, C. S. (2022) · Current Vascular Pharmacology · doi:10.2174/1570161121666221118155136 · Cited by 21 · see citing works
Arslan, M. S., Turhan, S., Dinçer, İ., Mızrak, D., Çorapçıoğlu, D., & Idılman, R. (2014) · Diabetology & Metabolic Syndrome · doi:10.1186/1758-5996-6-109 · Cited by 17 · see citing works
Bjergfelt, S. S., Sørensen, I. M. H., Hjortkjær, H. Ø., Landler, N. E., Ballegaard, E. L. F., Biering‐Sørensen, T., Kofoed, K. F., Lange, T., Feldt‐Rasmussen, B., Sillesen, H. H., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260417 · Cited by 17 · see citing works
Huang, Y., Liu, Q., Xu, J., Zhu, W., Jiang, J., Tang, L., & Chen, M. (2020) · Clinical Hemorheology and Microcirculation · doi:10.3233/ch-190804 · Cited by 12 · see citing works
Shen, J. I., Nicholas, S. B., Williams, S., & Norris, K. C. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1251-4 · Cited by 10 · see citing works
Relationship between obesity and health problems in help-seeking military veterans
Williamson, V., Rossetto, A., & Murphy, D. (2019) · BMJ Military Health · doi:10.1136/jramc-2019-001155 · Cited by 6 · see citing works
Chen, C., Zhou, L., Zhou, Y., Tang, Y., Huang, Y., & Chen, M. (2023) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2023.108546 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Yun, B., Park, H., Ahn, S. H., Oh, J., Kim, B. K., & Yoon, J. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002920 · Cited by 34 · see citing works
Li, D., Xu, Z., Wang, F., Hu, Y., Zhang, X., Yang, J., Wan, Q., Zhang, N., & Liu, Y. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1686931 · Cited by 12 · see citing works
Comi, L., Giglione, C., Klinaku, F. T., Pialorsi, F., Tollemeto, V., Zurlo, M., Seneci, A., & Magni, P. (2024) · Food Frontiers · doi:10.1002/fft2.535 · Cited by 8 · see citing works
Metabolic dysfunction–associated steatotic liver disease and cardiovascular disease
Laeeq, T., & Tun, K. M. (2024) · Clinical Liver Disease · doi:10.1097/cld.0000000000000181 · Cited by 3 · see citing works
Association between ALBI score and stroke risk and all-cause mortality: 2011 to 2018 NHANES
Wang, T., Wang, F., Zhang, Y., Zhang, X., & Zhang, Y. (2025) · Medicine · doi:10.1097/md.0000000000046377 · Cited by 2 · see citing works
Pan, J., Zeng, H., Song, Y., Zhang, X., Wang, Z., Tang, L., Xie, B., Peng, R., Zhou, Y., & Liu, B. (2025) · Acta Diabetologica · doi:10.1007/s00592-025-02536-w · Cited by 1 · see citing works
Coskun, B., Dizdar, O. S., Çakır, I., & Koç, A. (2026) · Nigerian Journal of Clinical Practice · doi:10.4103/njcp.njcp_509_25 · Cited by 1 · see citing works
Coşkun, B. D. Ö., Dizdar, O. S., Çakır, I., & Koç, A. (2025) · Research Square · doi:10.21203/rs.3.rs-7279629/v1
Coutinho, D. A. D. A., Godinho, J. R., Moura, R. C., de Oliveira, R. D. V. C., Passos, H. F., Mendes, J. D. P. F., de Andrade, C. R. M., Velarde, L. G. C., Saad, M. A. N., Pollo‐Flores, P., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20240856
Coutinho, D. A. D. A., Godinho, J. R., Moura, R. C., de Oliveira, R. D. V. C., Passos, H. F., Mendes, J. D. P. F., de Andrade, C. R. M., Velarde, L. G. C., Saad, M. A. N., Pollo‐Flores, P., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20240856i
Unveiling the Link between MASLD-Associated Liver Fibrosis and Subclinical Atherosclerosis
Izar, M. C. D. O., & Fonseca, F. A. H. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250503i
Desvendando a Ligação entre a Fibrose Hepática Associada ao DHEADM e a Aterosclerose Subclínica
Izar, M. C. D. O., & Fonseca, F. A. H. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250503
Pérez, B. G., Flores, R. S., Escobedo, R. D. L., Nava, F. V., Altamira‐García, J., & Ávila, J. P. (2025) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70287
Higher fibrosis-4 index is associated with 1-year in-stent restenosis after carotid artery stenting
Fujioka, T., Kanki, H., Gon, Y., Takasugi, J., Kawano, T., Kitano, T., Murakami, S., Furuya, S., Nakamura, H., Takagaki, M., et al. (2026) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2026.108760
- Authors
- Huang, Y., Wang, Y., Xiao, Z., Yao, S., Tang, Y., Zhou, L., Wang, Q., Xie, Y., Zhang, L., Zhou, Y., Lu, Y., Zhu, W., & Chen, M.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Corresponding author
- Chen, Man
- ORCID
- Venue
- BMC Cardiovascular Disorders
- Published
- 2023-11-11
- Volume
- 23
- Issue
- 1
- Pages
- 554-554
- ISSN
- 1471-2261 (ISSN-L)
- PMC
- PMC10640732
- OpenAlex
- W4388591473
- Cited by
- 16
- References
- 49
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 5
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Cardiovascular Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Shanghai Municipal Health and Family Planning Commission (No.20204Y0139, No.201940059)
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine (No. TRYJ2019(LC))
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- non-alcoholic fatty liver disease, cardiovascular and cerebrovascular diseases, carotid plaque thickness, carotid intima-media thickness, atherosclerosis, hepatic steatosis, free fatty acids, plaque vulnerability, contrast-enhanced ultrasound, risk factors
- MeSH terms
- Cardiovascular Diseases, Carotid Artery Diseases, Cerebrovascular Disorders, Fatty Liver, Humans, Risk Factors, Atherosclerosis, Plaque, Atherosclerotic, Carotid Intima-Media Thickness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
