Karakurt F, Carlioglu A, Koktener A, Ozbek M, Kaya A, Uyar M E, Kasapoglu B, Ilhan A
Division of Endocrinology, Department of Internal Medicine, Fatih University, Faculty of Medicine, Ankara, Turkey.
J Endocrinol Invest. 2009 Jan;32(1):63-8. doi: 10.1007/BF03345681.
Non-alcoholic fatty liver disease (NAFLD) is considered a risk factor for atherosclerosis. The aim of the present study was to investigate the association of the pulsatility index (PI) of basilar artery (BA) and carotid intima media thickness (IMT) in diabetic and non-diabetic NAFLD patients. We compared a group of 80 stroke-free, diabetic and non-diabetic NAFLD patients and a control group of 26 healthy subjects without NAFLD. We then evaluated the PI of the BA by transcranial Doppler ultrasonography, and carotid IMT. The PI was significantly higher in diabetic NAFLD patients than in controls (p<0.003). Carotid IMT and asymmetrical dimethylarginine (ADMA) levels were higher in NAFLD patients than controls respectively (p<0.003, p<0.04). The PI of the BA was significantly correlated with age (R=0.369, p<0.001), male gender (R=0.207, p=0.035), diabetes (R=0.332, p=0.001), carotid IMT (R=0.296, p=0.002) and ADMA (R=0.349, p=0.015). A multiple regression analysis was performed with PI as the dependent variable with known clinical risk factors. Age (beta=3.54, p<0.001), diabetes (beta=2.32, p=0.022), gender (beta=2.20, p<0.03), ADMA (beta=2.25, p<0.031), and carotid IMT (beta=2.41, p<0.017), were independent predictive factors of BA PI. Adjustment for age and gender did not alter these relative risks, exhibiting a significant independent contribution to PI. The increased PI observed in this study represents enhanced cerebrovascular resistance, and we observed that the age, male gender, diabetes, ADMA levels, and carotid IMT were independent predictive factors of BA PI.
非酒精性脂肪性肝病（NAFLD）被认为是动脉粥样硬化的一个危险因素。本研究的目的是调查糖尿病和非糖尿病NAFLD患者基底动脉（BA）搏动指数（PI）与颈动脉内膜中层厚度（IMT）之间的关联。我们比较了一组80例无中风的糖尿病和非糖尿病NAFLD患者以及一组26例无NAFLD的健康受试者作为对照组。然后，我们通过经颅多普勒超声评估BA的PI以及颈动脉IMT。糖尿病NAFLD患者的PI显著高于对照组（p<0.003）。NAFLD患者的颈动脉IMT和不对称二甲基精氨酸（ADMA）水平分别高于对照组（p<0.003，p<0.04）。BA的PI与年龄（R=0.369，p<0.001）、男性（R=0.207，p=0.035）、糖尿病（R=0.332，p=0.001）、颈动脉IMT（R=0.296，p=0.002）和ADMA（R=0.349，p=0.015）显著相关。以PI作为因变量，对已知临床危险因素进行多元回归分析。年龄（β=3.54，p<0.001）、糖尿病（β=2.32，p=0.022）、性别（β=2.20，p<0.03）、ADMA（β=2.25，p<0.031）和颈动脉IMT（β=2.41，p<0.017）是BA PI的独立预测因素。对年龄和性别进行校正并未改变这些相对风险，显示出对PI有显著的独立贡献。本研究中观察到的PI升高代表脑血管阻力增加，并且我们观察到年龄、男性、糖尿病、ADMA水平和颈动脉IMT是BA PI的独立预测因素。
