Abstract: Objective The aim of this study was to investigate the changes of serum hypoxia inducible factor-1α (HIF-1α), high-mobility group box 1 (HMGB1) and adiponectin (APN) levels in patients with non-alcoholic fatty liver diseases (NAFLD) and their correlation to carotid atherosclerosis (CAS). Methods 158 patients with NAFLD, including concomitant CAS in 71 cases, were encountered in our hospital between May 2018 and March 2023, and the NAFLD was diagnosed based on Fibrotouch detection and the CAS was determined by ultrasonography. Serum HIF-1α, HMGB1 and APN levels were assayed by ELISA, the risk factors was revealed by multivariate Logistic regression analysis and predicting performance was evaluated by the area under the receiver operating characteristic curve (AUC). Results The systolic blood pressure in patients NAFLD and concomitant CAS was(137.1±10.3)mmHg, much higher than in NAFLD patients without CAS; serum TC, LDL-C, HIF-1α and HMGB1 levels were (6.5±2.3)mmol/L, (3.7±0.6)mmol/L, (25.7±6.5)pg/L and (9.4±2.3)ng/ml, all significantly higher than , while serum APN level was (7.5±3.0)mg/L, much lower than in those without CAS; the multivariate Logistic regression analysis showed that serum TC(OR=1.411, 95%CI:1.133-1.757), LDL-C(OR=1.419, 95%CI:1.128-1.785), HIF-1α(OR=1.504, 95%CI:1.182-1.914), HMGB1(OR=1.520, 95%CI:1.206-1.916) and APN(OR=1.530, 95%CI:1.226-1.909) were all the risk factors impacting CAS occurrence in patient with NAFLD (P<0.05); the ROC analysis demonstrated that the AUC was 0.863, with the sensitivity of 94.5% and the specificity of 75.0% when the combination of serum HIF-1α, HMGB1 and APN levels was applied to predict the CAS existence, much superior to any single parameter did (P<0.05). Conclusion The elevated serum HIF-1α and HMGB1 levels and the decreased serum APN level are all risk factors for the occurrence of CAS in patients with NAFLD, which might be intervened as sooner as possible.

Key words: Non-alcoholic fatty liver diseases, Carotid atherosclerosis, Hypoxia inducible factor-1α, High-mobility group box 1, Adiponectin, Diagnosis