Department of Gastroenterology, Marmara University School of Medicine, Tophanelioglu Cad. No: 13/15 Altunizade, 34662 Istanbul, Turkey.
Atherosclerosis. 2010 Jul;211(1):182-6. doi: 10.1016/j.atherosclerosis.2010.01.049. Epub 2010 Feb 7.
Nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular disease. Coronary flow reserve (CFR) is widely used to examine the integrity of coronary microvascular circulation. We evaluated the prevalence of impaired CFR in patients with biopsy-proven NAFLD. We also investigated the independent clinical, biochemical, and liver histology predictors of CFR in the setting of NAFLD.
Fifty-nine consecutive patients with NAFLD and 77 age- and gender-matched controls were evaluated. CFR recordings were performed by transthoracic Doppler harmonic echocardiography. CFR>or=2.0 was considered normal.
CFR was significantly lower in patients with NAFLD than in controls (2.11+/-0.45 vs. 2.52+/-0.62, P<0.001). An impaired CFR (i.e. <2) was found in 25 NAFLD patients (42.4%) whereas all controls had normal CFR values (P<0.001). A stepwise linear regression analysis in NAFLD patients identified liver fibrosis scores as the only independent predictor of CFR values (beta=-0.60; t=-2.44, P=0.021).
Our findings indicate that in patients with biopsy-proven NAFLD: (a) an abnormal CFR is found in approximately 42.4% of cases, and (b) liver fibrosis scores are an independent predictor of depressed CFR.
非酒精性脂肪性肝病（NAFLD）与心血管疾病风险增加相关。冠状动脉血流储备（CFR）广泛用于检查冠状动脉微血管循环的完整性。我们评估了经活检证实的 NAFLD 患者中 CFR 受损的患病率。我们还研究了 NAFLD 患者中 CFR 的独立临床、生化和肝脏组织学预测因素。
评估了 59 例连续的 NAFLD 患者和 77 例年龄和性别匹配的对照者。通过经胸多普勒谐波超声心动图进行 CFR 记录。CFR≥2.0 被认为正常。
NAFLD 患者的 CFR 明显低于对照组（2.11±0.45 对 2.52±0.62，P＜0.001）。25 例 NAFLD 患者（42.4%）存在受损的 CFR（即＜2），而所有对照组的 CFR 值均正常（P＜0.001）。NAFLD 患者的逐步线性回归分析确定肝纤维化评分是 CFR 值的唯一独立预测因素（β=-0.60；t=-2.44，P=0.021）。
我们的研究结果表明，在经活检证实的 NAFLD 患者中：（a）约 42.4%的患者存在异常的 CFR；（b）肝纤维化评分是 CFR 降低的独立预测因素。
