Abstract

Background: The atherosclerosis and its complications may be less prevalent in patients with liver cirrhosis. However, the mechanisms underlying this observation remain unclear. This study aimed to evaluate the frequency of subclinical atherosclerosis and associated biochemical factors in patients with cirrhosis.

Methods: This case–control study included 49 patients with liver cirrhosis and 28 age- and sex-matched healthy controls. Subclinical atherosclerosis was assessed by Doppler ultrasonography measuring carotid intima–media thickness (CIMT) and the presence of carotid plaques. Laboratory parameters associated with atherosclerosis, including lipid profile, lipoprotein(a), oxidized low-density lipoprotein (oxLDL), insulin, homocysteine, platelet count, fibrinogen, high-sensitivity C-reactive protein (hsCRP), and bilirubin levels, were analyzed. Statistical analyses were performed using Student’s t-test or Mann–Whitney U test as appropriate, with p < 0.05 considered statistically significant.

Results: Mean CIMT was significantly lower in cirrhotic patients compared with controls (0.664 ± 0.133 mm vs. 0.749 ± 0.091 mm, p = 0.002). Carotid plaque was detected in 18.4% of patients and 14.3% of controls. Cirrhotic patients had significantly higher oxLDL levels, whereas total cholesterol, LDL-cholesterol, triglycerides, lipoprotein(a), platelet counts, and fibrinogen levels were significantly lower compared with controls. hsCRP levels were significantly higher in the cirrhosis group. No significant differences were observed in HDL cholesterol, blood pressure, body mass index, or homocysteine levels between groups.

Conclusion: Despite the presence of potential pro-atherogenic factors such as insulin resistance and elevated oxLDL levels, cirrhotic patients demonstrated lower carotid intima–media thickness, suggesting reduced subclinical atherosclerosis. Decreased lipid levels, thrombocytopenia, and hyperbilirubinemia may contribute to this paradoxical finding.

Keywords: liver cirrhosis, subclinical atherosclerosis, carotid intima–media thickness, oxidized LDL

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Copyright (c) 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to Cite

1.
Taşçı M, Ümit HC. Subclinical atherosclerosis and related factors in patients with liver cirrhosis: a case–control study. J Trends Med Invest. 2026;2(1):31-43. https://doi.org/10.64512/JTMI.2026.26

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