Patel Sumaiya, Lawlor Debbie A, Ferreira Diana L S, Hughes Alun D, Chaturvedi Nish, Callaway Mark, Day Chris, Sattar Naveed, Fraser Abigail
aSchool of Social and Community Medicine bMRC Integrative Epidemiology Unit at the University of Bristol, Bristol cInstitute of Cardiovascular Science, University College London, London dUniversity Hospitals Bristol National Health Service Foundation Trust, Bristol eInstitute of Cellular Medicine (C.D.), Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne fInstitute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, University of Glasgow, Glasgow, UK.
J Hypertens. 2015 Mar;33(3):546-52; discussion 553. doi: 10.1097/HJH.0000000000000445.
We aimed to determine the association of nonalcoholic fatty liver disease (NAFLD) with central and peripheral blood pressure (BP), in a general adolescent population and to examine whether associations are independent of adiposity.
Using cross-sectional data from a subsample (N = 1904) of a UK birth cohort, we assessed markers of NAFLD including ultrasound scan (USS) determined fatty liver, shear velocity (marker of liver fibrosis), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) at a mean age of 17.8 years. These were related to BP [central and peripheral SBP and DBP and mean arterial pressure (MAP)].
Fatty liver was positively associated with central and peripheral SBP, DBP and MAP in models adjusting for age, sex, social class, puberty and alcohol intake. These positive associations were attenuated to the null when fat mass was included. For example, in confounder-adjusted models, not including fat mass, mean central SBP was 3.74 mmHg [95% confidence interval (CI) 1.12 to 6.36] higher in adolescents with USS fatty liver than in those without; with additional adjustment for fat mass, the association attenuated to the null value (-0.37 mmHg; 95% CI -3.09 to 2.36). Similar patterns were found for associations of ALT and GGT with central and peripheral BP. There was no consistent evidence of associations of shear velocity or AST with BP measurements. Fatty liver was not consistently associated with central pulse pressure (PP), peripheral PP and Aix@75.
NAFLD is not associated with higher central or peripheral BP in adolescents once confounding by adiposity is taken into account.
我们旨在确定在普通青少年人群中,非酒精性脂肪性肝病(NAFLD)与中心和外周血压(BP)之间的关联,并研究这些关联是否独立于肥胖。
利用来自英国一个出生队列的子样本(N = 1904)的横断面数据,我们在平均年龄17.8岁时评估了NAFLD的标志物,包括超声扫描(USS)确定的脂肪肝、剪切波速度(肝纤维化标志物)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰转移酶(GGT)。这些指标与血压[中心和外周收缩压、舒张压及平均动脉压(MAP)]相关。
在调整了年龄、性别、社会阶层、青春期和酒精摄入量的模型中,脂肪肝与中心和外周收缩压、舒张压及平均动脉压呈正相关。当纳入脂肪量时,这些正相关减弱至无关联。例如,在未纳入脂肪量的混杂因素调整模型中,超声诊断为脂肪肝的青少年的平均中心收缩压比无脂肪肝者高3.74 mmHg [95%置信区间(CI)1.12至6.36];在进一步调整脂肪量后,该关联减弱至零值(-0.37 mmHg;95% CI -3.09至2.36)。ALT和GGT与中心和外周血压的关联也呈现类似模式。没有一致的证据表明剪切波速度或AST与血压测量值之间存在关联。脂肪肝与中心脉压(PP)、外周PP和Aix@75之间没有一致的关联。
一旦考虑到肥胖的混杂作用,NAFLD与青少年较高的中心或外周血压无关。