期刊论文详细信息
Diabetology & Metabolic Syndrome
A potential link between endothelial function, cardiovascular risk, and metabolic syndrome in patients with Non-alcoholic fatty liver disease
Ramazan Idilman1  Demet Corapcioglu2  Dilsa Mizrak4  Irem Dincer3  Sibel Turhan3  Muyesser Sayki Arslan4 
[1] Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey;Department of Endocrinology and Metabolism, Ankara University, School of Medicine, Ankara, Turkey;Department of Cardiology, Ankara University, School of Medicine, Ankara, Turkey;Department of Internal Medicine, Ankara University, School of Medicine, Yeni Ziraat Mah. 656. sok. 22/4. Altındağ, Ankara, Turkey
关键词: Cardiovascular risk;    Endothelial function;    Asymmetric dimethylarginine;    Metabolic syndrome;    Non-alcoholic fatty liver disease;   
Others  :  1114941
DOI  :  10.1186/1758-5996-6-109
 received in 2014-04-21, accepted in 2014-09-30,  发布年份 2014
PDF
【 摘 要 】

Background

Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthetase. Elevated ADMA reduces NO formation and is associated with endothelial dysfunction. The aims of this study were to evaluate endothelial function and the cardiovascular risk (CVR) profile in patients with non-alcoholic fatty liver disease (NAFLD), and to determine whether or not an association with metabolic syndrome (MS) increases these parameters.

Methods

A total of 100 consecutive patients with NAFLD, who were seen in Liver Disease Outpatient clinic and 45 age- and sex-matched controls were included. Endothelial function was evaluated based on the serum ADMA level measured using a validated ELISA kit (DLD Diagnostika GMBH, Hamburg, Germany) and flow-mediated vasodilatation (FMV) measured via high-resolution external ultrasonography. The CVR profile was calculated according to the Framingham equation.

Results

At baseline there weren’t any significant differences in brachial artery diameter between the NAFLD and control groups (3.7 ± 0.6 mm vs. 3.6 ± 0.6 mm, respectively). FMV and flow-independent vasodilatation in response to sublingual nitroglycerin did not differ between the NAFLD and control groups (mean: 16% ± 9.4% vs. 17.9% ± 12.4%, and 21.4% ± 14% vs. 17.8% ± 11.3%, respectively, p > 0.05). No significant difference in the serum ADMA concentration between the NAFLD and control groups was observed (mean: 0.8 ± 0.07 μmol L-1 vs. 0.74 ± 0.2 μmol L-1, respectively). The CVR profile was significantly higher in the NAFLD group than in the control group (mean: 9% ± 6.9% vs. 4.6% ± 3.8%, P = 0.000). MS associated with NAFLD significantly increased the CVR profile (mean: 11.2% ± 7.4%, P = 0.000). An abnormal serum alanine aminotransferase level (>37 IU L-1) and the presence of fibrosis did not increase the CVR profile (p > 0.05).

Conclusions

The risk of cardiovascular events is increased in patients with NAFLD. The association with MS is further increased such risk.

【 授权许可】

   
2014 Sayki Arslan et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150205030835138.pdf 233KB PDF download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Ludwig J, Viggiano TR, McGill DB, Oh BJ: Nonalcoholic steatohepatitis. Mayo Clinic Proc 1980, 55:434-438.
  • [2]Bellentani S, Saccoccio G, Masutti F, Crocè LS, Brandi G, Sasso F, Cristanini G, Tiribelli : Prevalance of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 2000, 132:112-117.
  • [3]Chitturi S, Farrell GC, George J: Non-alcoholic steatohepatitis in the Asia- Pacific region: future shock? J Gastroenterol Hepatol 2004, 19:368-374.
  • [4]Hamaguchi M, Kojima T, Takeda N, Nakagawa T, Taniguchi H, Fujii K, Omatsu T, Nakajima T, Sarui H, Shimazaki M, Kato T, Okuda J, Ida K: The metabolic syndrome as a predictor of non-alcoholic fatty liver disease. Ann Intern Med 2005, 143:722-778.
  • [5]Palmer RM, Ferrige AG, Moncada S: Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987, 327:524-526.
  • [6]Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, Ferrell LD, Liu YC, Torbenson MS, Unalp-Arida A, Yeh M, McCullough AJ, Sanyal AJ, Nonalcoholic Steatohepatitis Clinical Research Networ: Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005, 41:1313-1321.
  • [7]Juonala M, Jorma SA, Georg A, Marniemi J, Kähönen M, Taittonen L, Laitinen T, Raitakari OT: Brachial artery flow-mediated dilation and asymmetrical dimethylarginine in the cardiovascular risk in young Finns study. Circulation 2007, 116:1367-1373.
  • [8]Steinberg HO, Tarshoby A, Monestel R, Hook G, Cronin J, Johnson A, Bayazeed B, Baron AD: Elevated circulating free fatty acid levels impair endothelium dependent vasodilatation. J Clin Invest 1997, 100:1230-1239.
  • [9]Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR: Non-alcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol 1999, 94:2467-2474.
  • [10]Expert Panel on Detection: Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285:2486-2497.
  • [11]Committee G: 2003 European Society ve Hypertension–European Society of Cardiology guidelines fort the management of arteriel hypertension. J Hypertens 2003, 21:1011-1053.
  • [12]Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28:412-419.
  • [13]Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Loyd JK, Deanfield JE: Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992, 340:1111-1115.
  • [14]D'Agostino RB Srl, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008, 117(6):743-753. doi:10.1161/CIRCULATIONAHA.107.699579. Epub 2008 Jan 22
  • [15]Szuba A, Maciej P: Asymmetric dimethylarginine (ADMA) a novel cardiovascular risk factor-evidence from epidemiological and prospective clinical trials. Pharmacol Rep 2006, 57:16-20.
  • [16]Villanova N, Moscatiella S, Ramili S, Bugianesi E, Magalotti D, Vanni E, Zoli M, Marchesini G: Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology 2005, 42:473-480.
  • [17]Şentürk O, Kocaman O, Hulagu S, Şahin T, Aygün C, Konduk T, Celebi A: Endothelial dysfunction in Turkish patients with non-alcoholic fatty liver disease. Intern Med J 2008, 38:183-189.
  • [18]Kasumov T, Edmison JM, Dasarathy S, Bennett C, Lopez R, Kalhan SC: Plasma levels of asymmetric dimethylarginine in patients with biopsy-proven nonalcoholic fatty liver disease. Metabolism 2011, 60(6):776-781. Epub 2010 Sep 23
  • [19]Colak Y, Senates E, Yesil A, Yilmaz Y, Ozturk O, Doganay L, Coskunpinar E, Kahraman OT, Mesci B, Ulasoglu C, Tuncer I: Assessment of endothelial function in patients with nonalcoholic fatty liver disease. Endocrine 2013, 43(1):100-107. doi:10.1007/s12020-012-9712-1. Epub 2012 Jun 3
  • [20]Kim HC, Kim DJ, Huh KB: Association between nonalcoholic fatty liver disease and carotid intima-media thickness according to the presence of metabolic syndrome. Atherosclerosis 2009, 204(2):521-525. Epub 2008 Sep 19
  • [21]Blann AD, McCollum CN, Lip GY: Relationship between plasma markers of endothelial cell integrity and the Framingham cardiovascular disease risk-factor scores in apparently healthy individuals. Blood Coagul Fibrinolysis 202(13):513-518.
  • [22]Cupples LA, D’Agostino RB: Section 34: Some Risk Factors Related to the Annual Incidence of Cardiovascular Disease and Death in Pooled Repeated Biennial Measurements. In Framingham Heart Study: 30 Year Follow up. Edited by Kannel WB, Wolf PA, Garrison RJ. Bethesda, Md: US Department of Health and Human Services; 1987.
  • [23]Fonseca VA: Risk factors for coronary heart disease in diabetes. Ann Intern Med 2000, 133:154-156.
  • [24]Schwimmer JB, Deutsch R, Behling C: Fatty liver as a determinant of atherosclerosis. Hepatology 2005, 42:610A. [Abstract#1053]
  文献评价指标  
  下载次数:4次 浏览次数:24次