Increased arterial stiffness and impaired endothelial function in nonalcoholic Fatty liver disease: a pilot study.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease both in the general and pediatric population and has been associated with increased cardiovascular risk. Arterial function and early atherosclerotic changes are markers of cardiovascular disease and independent predictors of the corresponding risk. Through a global approach, we investigated the relationships between NAFLD and functional arterial changes and early atherosclerosis.


METHODS
A total of 23 consecutive patients (mean age 55 ± 14 years, 11 males) with biopsy evidence of NAFLD and 28 control subjects matched for age, gender, body mass index, and other cardiovascular risk factors participated in the study.


RESULTS
Compared to controls, NAFLD subjects had significantly higher carotid-femoral pulse wave velocity (PWV; 8.2 ± 1.3 m/s vs. 6.9 ± 1.3 m/s, P = 0.001), higher carotid intima-media thickness (IMT; 0.79 ± 0.18 mm vs. 0.67 ± 0.13 mm, P = 0.01), and reduced flow-mediated dilatation (FMD; 1.92 ± 2.11% vs. 4.8 ± 2.43%, P < 0.001). In multivariable analysis, presence of NAFLD was an independent determinant of both PWV and FMD, whereas leptin was an independent determinant of PWV (B = 0.036, P < 0.05), and adiponectin was independently associated with FMD (B = 0.104, P < 0.05). In addition, histological activity of liver disease expressed by the global Brunt Grade was associated independently with FMD (B = -1.054, P < 0.05).


CONCLUSIONS
NAFLD is associated with arterial stiffness and endothelial dysfunction. Given the important independent prognostic role of these arterial indexes, these findings have important implications for increased cardiovascular risk in patients with NAFLD.
Vlachopoulos
Charalambos
C
Department of Cardiology, Athens Medical School, Hippokration General Hospital, Greece. cvlachop@otenet.gr
Manesis
Emanuel
E
Baou
Katerina
K
Papatheodoridis
George
G
Koskinas
John
J
Tiniakos
Dina
D
Aznaouridis
Konstantinos
K
Archimandritis
Athanasios
A
Stefanadis
Christodoulos
C
D054392:Adipokines / Q000097:blood; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001783:Blood Flow Velocity / Q000502:physiology; D002339:Carotid Arteries / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010865:Pilot Projects; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology
D054392:Adipokines; D015415:Biomarkers