Institute of Clinical Medicine, Department of Internal Medicine and Biocenter Oulu, Finland.
J Hypertens. 2012 Oct;30(10):2015-9. doi: 10.1097/HJH.0b013e3283576faf.
Nonalcoholic fatty liver and hypertension are associated with metabolic syndrome. Both conditions increase the risk for cardiovascular morbidity. The objective of this study was to analyze whether 24-h blood pressure (BP) levels and nondipping phenomenon associate with hepatic steatosis defined as liver brightness.
Twenty-four hour ambulatory BP measurement (ABPM) and liver brightness were investigated in a population-based cohort of 890 hypertensive (n = 433) and normotensive (n = 457) individuals aged 40-60 years. ABPM was recorded using the fully automatic SpaceLabs90207 oscillometric unit.
Fatty liver was associated with male sex, increased alcohol consumption, high BMI, large waist (P < 0.001 for all) and increased prevalence of smoking (P < 0.03). Values of alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), triglycerides and high-sensitivity CRP (hsCRP) were higher and high-density lipoprotein cholesterol lower (P < 0.001 for all) in individuals with fatty liver. After adjustments for BMI, sex and age, fatty liver was associated with 24-h (P < 0.005), daytime (P < 0.02) and night-time (P < 0.005) SBP measurements and DBP at daytime (P < 0.03). The association with nondipping showed only a trend (P = 0.057).
Significantly higher ambulatory daytime and night-time SBP levels were seen in individuals with fatty liver. Nondipping does not seem to associate with liver fat. The coexistence of liver fat accumulation and high BP are likely to potentiate the risk for cardiovascular disease.
非酒精性脂肪肝和高血压与代谢综合征有关。这两种情况都会增加心血管疾病发病风险。本研究旨在分析 24 小时血压(BP)水平和非杓型现象是否与肝脂肪变性(定义为肝脏亮度)相关。
对一个 40-60 岁的基于人群的高血压(n=433)和正常血压(n=457)个体队列进行了 24 小时动态血压测量(ABPM)和肝脏亮度检查。ABPM 使用全自动 SpaceLabs90207 示波法单元进行记录。
脂肪肝与男性、饮酒增加、BMI 高、腰围大(所有 P<0.001)和吸烟流行率高(P<0.03)有关。脂肪肝患者的丙氨酸氨基转移酶(ALT)、γ-谷氨酰转移酶(GGT)、甘油三酯和高敏 C 反应蛋白(hsCRP)水平更高,高密度脂蛋白胆固醇水平更低(所有 P<0.001)。在校正 BMI、性别和年龄后,脂肪肝与 24 小时(P<0.005)、白天(P<0.02)和夜间(P<0.005)SBP 测量值以及白天 DBP(P<0.03)有关。与非杓型的相关性仅呈趋势(P=0.057)。
脂肪肝患者的日间和夜间 ABPM 水平明显更高。非杓型似乎与肝脂肪无关。肝脂肪堆积和高血压并存可能会增加心血管疾病的风险。