Beyond Pigmentation: Interplay of Metabolic Profile, Carotid Intima-Media Thickness, and Fatty Liver in Vitiligo: An Age- and Sex-Matched Case-Control Study

Background and aims: Vitiligo shares inflammatory and metabolic pathways with cardiovascular and hepatic steatosis. Carotid intima-media thickness (IMT) is an established marker of early subclinical atherosclerosis, whereas non-alcoholic fatty liver disease (NAFLD) reflects hepatic involvement in chronic inflammatory and metabolic dysregulation. This study aimed to evaluate subclinical vascular and hepatic changes in patients with vitiligo and to explore their associations with disease characteristics and metabolic parameters.

Methods

In this age- and sex-matched case-control study, adults with mild vitiligo (Vitiligo Area Severity Index [VASI] < 5%) and no metabolic syndrome were compared with healthy controls. Participants underwent carotid duplex ultrasonography to assess common carotid IMT and atherosclerotic plaques, liver ultrasonography for steatosis grading, and laboratory testing, including lipid profile (total cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides [TG]), fasting blood glucose (FBS), and body mass index (BMI). Disease duration and VASI score were also assessed.