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
