Endothelial dysfunction and non-alcoholic liver steatosis in hypertensive patients.
OBJECTIVE
Non-alcoholic fatty liver disease, characterized by insulin resistance, has been correlated with several clinical and pathological manifestations, such as intima-media thickness. At present, no data are available regarding endothelial dysfunction, the first step in atherosclerosis, and non-alcoholic fatty liver disease. The aim of this study was to test a possible association between non-alcoholic fatty liver disease and endothelium-dependent vasodilation in a group of hypertensive patients.


RESULTS
A total of 40 never-treated uncomplicated hypertensive outpatients were enrolled. Patients underwent a complete clinical and biochemical work-up including ultrasonographic scanning to detect liver steatosis. Insulin sensitivity was estimated by using the homeostasis model assessment (HOMA) index. Endothelial function was assessed by strain-gauge plethysmography during intra-arterial infusion of increasing doses of acetylcholine and sodium nitroprusside. Endothelium-dependent vasodilation was significantly reduced in hypertensive patients with liver steatosis in comparison with those without. Statistical analysis demonstrated that the HOMA index was the strongest predictor of both endothelium-dependent vasodilation and liver steatosis. In particular, one point of HOMA accounts for 37.9% of forearm blood flow variation, and increases the risk of liver steatosis by 86.4%.


CONCLUSIONS
Our data demonstrate that hypertensive patients with liver steatosis have a reduced endothelium-dependent vasodilation and highest insulin resistance. In keeping with this, it is possible to hypothesize that liver steatosis may be considered a marker of vascular damage in essential hypertension.
Department of Experimental and Clinical Medicine, G. Salvatore, University Magna Græcia of Catanzaro, Italy.
A
A
Sciacqua
M
M
Perticone
S
S
Miceli
I
I
Laino
E J
EJ
Tassone
R D
RD
Grembiale
F
F
Andreozzi
G
G
Sesti
F
F
Perticone
D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015415:Biomarkers; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside / Q000494:pharmacology; D010991:Plethysmography; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology
D015415:Biomarkers; D014665:Vasodilator Agents; D009599:Nitroprusside; D000109:Acetylcholine