Relationship between retinal vascular caliber and coronary artery disease in patients with non-alcoholic fatty liver disease (NAFLD)
Open accessAbstract
OBJECTIVE: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. METHODS: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. RESULTS: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). CONCLUSIONS: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.
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Metformin improves ALT but not histological steatosis, inflammation and fibrosis in individuals with MASLD.
“Metformin improves ALT but not histological steatosis, in fl ammation and fi brosis in individuals with MASLD.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [461]
The Methods and Results describe CT-based assessment of NAFLD and vascular outcomes, not metformin treatment or changes in liver histology. Searches for metformin, ALT improvement, and histological steatosis, inflammation, and fibrosis found no passage addressing the claimed treatment effect. The copy does not establish a contrary effect either. (LLM, conf=0.76)
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Cai, J. X., Zhang, S., & Huang, W. (2015)
- Authors
- Josef, P., Ali, I., Ariel, P., Alon, M., & Nimer, A.
- Affiliations
- Bar-Ilan University (IL)
- Rebecca Sieff Hospital (IL)
- Department of Radiology, Safed 13100, Israel
- Faculty of Medicine at Galilee, Bar Ilan University, Safed 13100, Israel
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2013-08-06
- Volume
- 10
- Issue
- 8
- Pages
- 3409-3423
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC3774445
- OpenAlex
- W2110099323
- Cited by
- 22
- References
- 63
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2016: 1 · 2015: 5 · 2014: 3 · 2013: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- non-alcoholic fatty liver disease, coronary artery disease, retinal vessel diameter, arteriole-to-venule ratio, intima-media thickness, carotid atherosclerosis, coronary artery stenosis, insulin resistance, metabolic syndrome, triglycerides, cardiovascular risk, retinal angiography, hepatic steatosis, inflammatory markers, oxidant-antioxidant status
- MeSH terms
- Adult, Arterioles, Coronary Artery Disease, Fatty Liver, Female, Humans, Male, Middle Aged, Radiography, Retinal Vessels, Spleen, Ultrasonography, Venules, Case-Control Studies, Non-alcoholic Fatty Liver Disease
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 ›
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