Illustration of a healthy liver and carotid artery intertwined, symbolizing the connection between liver and heart health.

Unlocking Heart Health: How Liver Health and Enzyme Levels Can Predict Your Risk

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"Elevated liver enzymes and fatty liver: Understanding their surprising link to carotid plaque and cardiovascular health."

Cardiovascular disease (CVD) remains a leading cause of death worldwide, making early detection and prevention critical. Atherosclerosis, the underlying cause of many CVD cases, involves the buildup of plaque in the arteries, restricting blood flow and increasing the risk of heart attack and stroke. Carotid arteries, located in the neck, are particularly vulnerable to this plaque buildup.

Traditionally, factors like high blood pressure, elevated cholesterol, diabetes, and smoking have been recognized as major contributors to atherosclerosis. However, emerging research highlights the role of other factors, including liver health. Fatty liver disease, increasingly prevalent worldwide, and elevated levels of a liver enzyme called gamma-glutamyl transpeptidase (GGT) are now being investigated for their potential impact on cardiovascular health.

This article explores the connection between fatty liver, GGT levels, and carotid plaque, shedding light on how these factors can serve as early warning signs for potential cardiovascular issues. By understanding these links, you can take proactive steps to protect your heart health.

The Fatty Liver-Heart Connection: What the Research Reveals?

Illustration of a healthy liver and carotid artery intertwined, symbolizing the connection between liver and heart health.

Atherosclerosis is the pathological process behind various cardiovascular diseases, making the early identification of atherosclerosis a primary preventative measure. Carotid ultrasound is a common and non-invasive method used to assess the degree of atherosclerosis. This imaging technique helps healthcare professionals visualize the carotid arteries and measure the thickness of the artery walls, along with the presence of any plaque formation.

A recent study published in the Journal of Atherosclerosis and Thrombosis investigated the relationship between fatty liver, GGT levels, and carotid atherosclerosis. Researchers analyzed the medical records of 958 participants who underwent medical checkups, including carotid ultrasounds to assess plaque buildup and abdominal ultrasounds to determine the presence of fatty liver. Here's what they found:

Elevated GGT and Carotid Plaque: Higher GGT levels were significantly associated with the presence of carotid plaque.
Fatty Liver as a Predictor: Fatty liver, independent of other risk factors, correlated with the existence of carotid plaque.
The Combined Impact: The most striking finding was that the combination of elevated GGT levels and the presence of fatty liver significantly increased the likelihood of carotid plaque. Individuals with both conditions were at a considerably higher risk compared to those with only one or neither.

These findings suggest that the simultaneous presence of elevated GGT levels and fatty liver creates a synergistic effect, making it a strong predictor of carotid plaque. This highlights the importance of considering liver health as part of a comprehensive assessment of cardiovascular risk.

Take Control of Your Heart Health: What You Can Do

The good news is that both fatty liver and elevated GGT levels are often modifiable with lifestyle changes. If you're concerned about your risk, talk to your doctor about getting your GGT levels checked and discuss strategies for improving your liver health. Simple changes, such as adopting a healthy diet, exercising regularly, and limiting alcohol consumption, can make a significant difference in protecting your heart and overall well-being.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5551/jat.28274, Alternate LINK

Title: Elevated Serum Gamma-Glutamyl Transpeptidase Levels And Fatty Liver Strongly Predict The Presence Of Carotid Plaque

Subject: Biochemistry (medical)

Journal: Journal of Atherosclerosis and Thrombosis

Publisher: Japan Atherosclerosis Society

Authors: Nobuyuki Toshikuni, Takayoshi Asaji, Yumiko Nakanishi, Shin-Ya Nagasawa, Hiroaki Uenishi, Mikihiro Tsutsumi

Published: 2015-01-01

Everything You Need To Know

What is the connection between elevated liver enzymes and cardiovascular health?

Elevated levels of the liver enzyme gamma-glutamyl transpeptidase (GGT) have been linked to an increased risk of carotid plaque, a key indicator of cardiovascular disease. Research indicates that higher GGT levels correlate with the presence of carotid plaque, underscoring the importance of monitoring liver health as part of assessing cardiovascular risk. Furthermore, the combination of elevated GGT levels and fatty liver disease significantly heightens the likelihood of carotid plaque formation, increasing the overall risk of cardiovascular issues such as heart attack and stroke.

How does fatty liver contribute to the risk of carotid plaque?

Fatty liver disease, independent of other risk factors, has been shown to correlate with the existence of carotid plaque. The presence of fatty liver indicates potential underlying metabolic issues that can contribute to the development of atherosclerosis, the process by which plaque builds up in the arteries. When fatty liver is present alongside elevated GGT levels, the risk of carotid plaque increases significantly, suggesting a synergistic effect that amplifies cardiovascular risk. This highlights the need to address liver health as a crucial component of cardiovascular health management.

What is the role of carotid ultrasound in assessing cardiovascular health?

Carotid ultrasound is a non-invasive imaging technique used to assess the degree of atherosclerosis in the carotid arteries, which are located in the neck. This method helps healthcare professionals visualize the artery walls, measure their thickness, and identify the presence of plaque. Early detection of carotid plaque through carotid ultrasound is critical for preventing cardiovascular diseases like heart attack and stroke because it allows for timely intervention and management of risk factors.

What are the lifestyle changes that can improve both liver health and heart health?

Both fatty liver and elevated GGT levels are often modifiable through lifestyle changes. Adopting a healthy diet, exercising regularly, and limiting alcohol consumption can significantly improve liver function and, consequently, benefit cardiovascular health. These changes can help reduce the buildup of plaque in the arteries, thereby decreasing the risk of heart attack and stroke. Consulting with a healthcare provider to discuss and implement these lifestyle modifications is essential for effectively managing and improving both liver and heart health.

Why is the combination of elevated GGT levels and fatty liver a significant concern for cardiovascular risk?

The simultaneous presence of elevated GGT levels and fatty liver creates a synergistic effect, making it a strong predictor of carotid plaque and, by extension, cardiovascular risk. This combination indicates a heightened level of inflammation and metabolic dysfunction, which promotes the development of atherosclerosis. Individuals with both conditions face a considerably higher risk of developing carotid plaque compared to those with only one or neither condition. Therefore, managing both fatty liver and elevated GGT levels through lifestyle changes and medical interventions is vital for reducing overall cardiovascular risk.