title: Additive Effect of Non-Alcoholic Fatty Liver Disease on Metabolic Syndrome-Related Endothelial Dysfunction in Hypertensive Patients.
abstract: Metabolic syndrome (MS) is characterized by an increased risk of incident diabetes and cardiovascular (CV) events, identifying insulin resistance (IR) and endothelial dysfunction as key elements. Moreover, non-alcoholic fatty liver disease (NAFLD) is bidirectionally linked with MS as a consequence of metabolic and inflammatory abnormalities. We addressed the question if the evolution in NAFLD might worsen endothelium-dependent vasodilating response in MS hypertensives. We recruited 272 Caucasian newly-diagnosed never-treated hypertensive outpatients divided into three groups according to the presence/absence of MS alone or in combination with NAFLD. MS and NAFLD were defined according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and non-invasive fatty liver index, respectively. We determined IR by using the homeostasis model assessment (HOMA) index. Vascular function, as forearm blood flow (FBF), was determined through strain-gauge plethysmography after intra-arterial infusion of acetylcholine (ACh) and sodium nitroprusside. MS+NAFLD+ group showed worse metabolic, inflammatory and vascular profiles compared with MS-NAFLD- and MS+NAFLD-. HOMA resulted in being the strongest predictor of FBF both in the MS+NAFLD- and in the MS+NAFLD+ groups, accounting for 20.5% and 33.2% of its variation, respectively. In conclusion, we demonstrated that MS+NAFLD+ hypertensives show a worse endothelium-dependent vasodilation compared with MS+NAFLD-, allowing for consideration of NAFLD as an early marker of endothelial dysfunction in hypertensives.
authors.affiliation: Department of Experimental and Clinical Medicine, University Magna Græcia, Catanzaro 88100, Italy. mariaperticone@hotmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Perticone
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro 88100, Italy. antocime@hotmail.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cimellaro
authors.affiliation: Unit of Cardiovascular Diseases, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy. raf_maio@yahoo.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Maio
authors.affiliation: Unit of Cardiovascular Diseases, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy. benedettocaroleo@libero.it.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Caroleo
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro 88100, Italy. sciacqua@unicz.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Sciacqua
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro 88100, Italy. sesti@unicz.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro 88100, Italy. perticone@unicz.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology*; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009599:Nitroprusside / Q000494:pharmacology; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D012039:Regional Blood Flow / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside; D000109:Acetylcholine
keywords: arterial hypertension; cardiovascular disease and risk; endothelial dysfunction; metabolic syndrome; non-alcoholic fatty liver disease