332 PEROXIDIZED FATTY ACIDS MAY INDUCE A PRO-INFLAMMATORY RESPONSE IN THE LIVER AND MAY TRIGGER THE OUTBREAK OF NON-ALCOHOLIC STEATOHEPATITIS (NASH)

Background: Retinal vessel diameter has been shown to be associated with CAD in the general population. However, it has not been studied in persons with NAFLD. Aim: Evaluate the relationship between Retinal vessel diameter and carotid arteries Intima-Media thickness (IMT) and coronary artery disease (CAD), in patients with NAFLD. Methods: 29 Patients with fatty liver (age 50±7) and low risk for CAD were included. Patients with Diabetes and Hypertension were excluded. 22 healthy individuals matched for age, gender and BMI served as controls. CAD was defined as a stenosis of >50% in at least 1 major coronary artery by Cardiac CT. Fatty Liver was defined as liver – spleen density (CT) <-10 HU. We measured (IMT) by Doppler US (IMT normal <0.7 women, <0.8 men), Retinal artery and vein diameter by retinal angiography, and biomarkers of insulin resistance, inflammation and oxidation. Results: NAFLD patients showed higher prevalence of CAD (38% vs. 14%, P < 0.001), coronary plaques (67% vs. 34%, P < 0.001), Higher IMT (0.98±0.3 Vs 0.83±0.1, P < 0.04), higher carotid plaques (60% Vs 40%, P < 0.001) higher HOMA (4.0±3.4 vs. 2.0±1.0, P < 0.005) and higher TG levels (200±80 vs. 150±60, P < 0.005) but Lower retinal artery-vein ratio (0.66±0.06 Vs 0.71±0.02. P < 0.01) and narrower retinal artery diameter (92.4±13 Vs 100.6±7, P < 0.04) than healthy controls. No significant difference in CRP, MDA, and Paraoxonase biomarkers levels was noted between the two groups. Multiple logistic regression showed IMT to be the strongest predictor of CAD (OR 2.3, CI 0.8–3.3, P < 0.001) in patients with NAFLD, followed by retinal A-V ratio (OR 1.5, CI 0.5–3, P < 0.01). Conclusion: Smaller retinal artery caliber and retinal A-V ratio may indicate an increased risk of CAD in patients with fatty liver even without diabetes and without hypertension.