Analysis of Quality Intima-Media Thickness and Quantitative Artery Stiffness technologies on non-alcoholic fatty liver disease: a study on carotid artery structure, elasticity, and influential factors in patients

Quant Imaging Med Surg. 2024 Dec 5;14(12):9049-9061. doi: 10.21037/qims-24-1179. Epub 2024 Nov 29.

Abstract

Background: In recent years, there have been numerous studies using Quality Intima-Media Thickness (QIMT) and Quantitative Arterial Stiffness (QAS) technology to evaluate various related factors and disease-induced changes in carotid artery (CA) elasticity. However, there is still a lack of research on the relationship between non-alcoholic fatty liver disease (NAFLD) and various indicators related to the CA. This study aimed to investigate the clinical significance of using QIMT and QAS techniques for comprehensive evaluation of CA intima-media thickness (IMT) and elasticity changes in NAFLD patients, and to analyze various factors influencing these variables.

Methods: In this cross-sectional study, a total of 196 healthy adults and 285 NAFLD patients were selected from June 2021 and October 2021 in the First Affiliated Hospital of Zhejiang University School of Medicine. Body mass index (BMI), blood pressure, and triglyceride levels were collected. CA IMT and pulse wave velocity (PWV) were measured using QIMT and QAS techniques. Multiple linear regression analysis was employed to explore the relationship between parameters measured using QIMT and QAS techniques and NAFLD, while controlling for covariates, to assess the measurement effects of QIMT and QAS techniques on arterial structure and elasticity in NAFLD patients.

Results: A total of 233 males and 248 females were included in this study, with 178 males (62.46%) and 107 females (37.54%) being diagnosed with NAFLD. Gender, age, systolic blood pressure (SBP), and uric acid (UA) all are related to CA IMT (estimated value -0.031 to 0.008, P<0.0001-P=0.0450). The presence of NAFLD was not significantly related to IMT, but primarily influenced vascular elasticity indicators α, β, PWV, augmentation index (Aix), distensibility coefficient (DC), and compliance coefficient (CC). Age, SBP, diastolic blood pressure (DBP), high-density lipoprotein (HDL), and UA were all related to vascular elasticity coefficient β (estimated value -0.05 to 1.03, P<0.0001-P=0.0451); SBP and UA had a relationship with PWV (estimated value -0.001 to 0.405, P<0.0001-P=0.0027); gender, age, SBP, DBP, and UA all influenced Aix (estimated value -0.17 to 0.65, P<0.0001-P=0.0072).

Conclusions: Ultrasound radiofrequency (RF) signal QIMT and QAS techniques can reflect changes in CA structure and elasticity function in NAFLD patients, which can be more widely applied and promoted in the changes of CA structure and elastic function in NAFLD patients.

Keywords: Non-alcoholic fatty liver disease (NAFLD); Quality Intima-Media Thickness technique (QIMT technique); Quantitative Arterial Stiffness technique (QAS technique); carotid artery (CA); intima-media thickness (IMT).