title: Aortic flow propagation velocity, epicardial fat thickness, and osteoprotegerin level to predict subclinical atherosclerosis in patients with nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in Western countries and an independent risk factor for atherosclerotic heart disease. Appropriate noninvasive parameters are lacking for optimal risk stratification of cardiovascular disease in these patients. We evaluated several recently discovered noninvasive parameters for atherosclerosis in patients with nonalcoholic fatty liver disease: epicardial fat thickness, aortic flow propagation velocity, and osteoprotegerin level.
  
  
  
  Forty-one patients (27 men and 14 women; mean age, 37.9±8.9 years) with nonalcoholic fatty liver disease and 37 control subjects (17 men and 20 women; mean age, 34.5±8.6 years) were enrolled in this observational case-control study. Patients with nonalcoholic fatty liver disease diagnosed at a gastroenterology outpatient clinic were included. Patients with cardiac pathology other than hypertension were excluded. Epicardial fat thickness and aortic flow propagation velocity were measured by echocardiography. The serum concentration of osteoprotegerin was measured using a commercial enzyme-linked immunosorbent assay kit.
  
  
  
  Nonalcoholic fatty liver disease patients exhibited a significantly lower aortic flow propagation velocity (155.17±30.00 vs. 179.00±18.14 cm/s, p=0.000) and significantly higher epicardial fat thickness (0.51±0.25 vs. 0.29±0.09 cm, p=0.000) than control subjects. Osteoprotegerin levels were higher, but not significant, in patients with nonalcoholic fatty liver disease (28.0±13.0 vs. 25.2±10.8 pg/mL, p=0.244). Binary logistic regression analysis showed that aortic flow propagation velocity (OR, -0.973; 95% CI, 0.947-0.999) and waist circumference (OR, -1.191; 95% CI, 1.088-1.303) were independent predictors of nonalcoholic fatty liver disease.
  
  
  
  In this study, epicardial fat thickness and osteoprotegerin level were higher and aortic flow propagation velocity was lower in patients with nonalcoholic fatty liver disease. Early detection of abnormal epicardial fat thickness and aortic flow propagation velocity may warrant a search for undetected cardiovascular disease in patients with nonalcoholic fatty liver disease.
authors.affiliation: Department of Cardiology, Başkent University İstanbul Hospital, İstanbul-Turkey. di_oguz@hotmail.com.
authors.forename: Didem
authors.initials: D
authors.lastname: Oğuz
authors.affiliation: Department of Gastroenterology, Şişli Florence Nightingale Hospital, İstanbul-Turkey.
authors.forename: Hakan Ümit
authors.initials: HÜ
authors.lastname: Ünal
authors.affiliation: Department of Biochemistry, Başkent University İstanbul Hospital, İstanbul-Turkey.
authors.forename: Hacer
authors.initials: H
authors.lastname: Eroğlu
authors.affiliation: Department of Cardiology, Başkent University İstanbul Hospital, İstanbul-Turkey.
authors.forename: Öykü
authors.initials: Ö
authors.lastname: Gülmez
authors.affiliation: Department of Radiology, Başkent University İstanbul Hospital, İstanbul-Turkey.
authors.forename: Halime
authors.initials: H
authors.lastname: Çevik
authors.affiliation: Department of Cardiology, Başkent University İstanbul Hospital, İstanbul-Turkey.
authors.forename: Armağan
authors.initials: A
authors.lastname: Altun
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D053244:Osteoprotegerin / Q000097:blood*; D010496:Pericardium; D012307:Risk Factors
chemical_list: D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human