Relationship between nonalcoholic fatty liver disease, metabolic disorders and pulse wave velocity

Seo, Ji A; Yoo, Hye Jin; Park, Soo Yeon; Kwon, Soon Beom; Ryu, Ohk Hyun; Park, Sang Soo; Kim, Hee Young; Lee, Kye Won; Kim, Sin Gon; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei Hyun; Choi, Dong Seop

Abstract

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is frequently associated with type 2 diabetes mellitus, obesity and dyslipidemia. Also, it is recognized to be one of component of the insulin resistance syndrome. But both its pathogenesis and clinical implication associated with cardiovascular disease as an important outcome of insulin resistance have not been well known. We investigated the relationship between NAFLD, metabolic disorders, and brachial-ankle pulse wave velocity (baPWV) as a risk marker of atherosclerosis.
METHODS
A total of 213 nonalcoholic subjects (67 males, 146 females) participated in this study. Subjects were divided into NAFLD or normal group based on the existence of fatty liver seen by sonography.
RESULTS
The prevalence of hypertension, impaired fasting glucose, hypertriglyceridemia, low HDL-C level and central obesity were higher in NAFLD group than those in normal group. After controlling for age, sex and body mass index, serum ALT, AST, ALP and GGT levels were significantly associated with homeostatis model assessment of insulin resistance (HOMA-IR) (p<0.05). baPWV in NAFLD group was significantly higher than those in normal group in females (p=0.005). After adjusting for age, NAFLD had positive correlation with baPWV (p=0.039). In addition, the positive correlation was stronger in NAFLD with elevated liver enzymes (p=0.011). Individual levels of serum ALT, AST, ALP and GGT were positively correlated with baPWV after adjusting for age, sex, body mass index, HOMA-IR and systolic blood pressure (p<0.05). A multiple regression analysis showed baPWV was significantly associated with age, systolic blood pressure, body mass index and various liver enzymes, respectively.
CONCLUSION
baPWV was significantly associated with NAFLD, especially in females. baPWV also had significant positive correlation with various liver enzymes. NAFLD showed more strong correlation with baPWV when it was combined with abnormal liver function. NAFLD, especially combined with abnormal liver function, may be associated with increased risk of cardiovascular disease.