Sayki Arslan Muyesser, Turhan Sibel, Dincer Irem, Mizrak Dilsa, Corapcioglu Demet, Idilman Ramazan
Department of Internal Medicine, Ankara University, School of Medicine, Yeni Ziraat Mah. 656. sok. 22/4. Altındağ, Ankara, Turkey.
Department of Cardiology, Ankara University, School of Medicine, Ankara, Turkey.
Diabetol Metab Syndr. 2014 Oct 14;6:109. doi: 10.1186/1758-5996-6-109. eCollection 2014.
Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthetase. Elevated ADMA reduces NO formation and is associated with endothelial dysfunction. The aims of this study were to evaluate endothelial function and the cardiovascular risk (CVR) profile in patients with non-alcoholic fatty liver disease (NAFLD), and to determine whether or not an association with metabolic syndrome (MS) increases these parameters.
A total of 100 consecutive patients with NAFLD, who were seen in Liver Disease Outpatient clinic and 45 age- and sex-matched controls were included. Endothelial function was evaluated based on the serum ADMA level measured using a validated ELISA kit (DLD Diagnostika GMBH, Hamburg, Germany) and flow-mediated vasodilatation (FMV) measured via high-resolution external ultrasonography. The CVR profile was calculated according to the Framingham equation.
At baseline there weren't any significant differences in brachial artery diameter between the NAFLD and control groups (3.7 ± 0.6 mm vs. 3.6 ± 0.6 mm, respectively). FMV and flow-independent vasodilatation in response to sublingual nitroglycerin did not differ between the NAFLD and control groups (mean: 16% ± 9.4% vs. 17.9% ± 12.4%, and 21.4% ± 14% vs. 17.8% ± 11.3%, respectively, p > 0.05). No significant difference in the serum ADMA concentration between the NAFLD and control groups was observed (mean: 0.8 ± 0.07 μmol L(-1) vs. 0.74 ± 0.2 μmol L(-1), respectively). The CVR profile was significantly higher in the NAFLD group than in the control group (mean: 9% ± 6.9% vs. 4.6% ± 3.8%, P = 0.000). MS associated with NAFLD significantly increased the CVR profile (mean: 11.2% ± 7.4%, P = 0.000). An abnormal serum alanine aminotransferase level (>37 IU L(-1)) and the presence of fibrosis did not increase the CVR profile (p > 0.05).
The risk of cardiovascular events is increased in patients with NAFLD. The association with MS is further increased such risk.
不对称二甲基精氨酸（ADMA）是一氧化氮（NO）合酶的内源性竞争性抑制剂。ADMA水平升高会减少NO生成，并与内皮功能障碍相关。本研究的目的是评估非酒精性脂肪性肝病（NAFLD）患者的内皮功能和心血管风险（CVR）概况，并确定与代谢综合征（MS）的关联是否会增加这些参数。
纳入了100例在肝病门诊连续就诊的NAFLD患者以及45例年龄和性别匹配的对照组。基于使用经过验证的ELISA试剂盒（德国汉堡DLD Diagnostika GMBH）测量的血清ADMA水平以及通过高分辨率外部超声测量的血流介导的血管舒张（FMV）来评估内皮功能。根据弗明汉方程计算CVR概况。
在基线时，NAFLD组和对照组之间肱动脉直径没有显著差异（分别为3.7±0.6mm和3.6±0.6mm）。NAFLD组和对照组之间对舌下硝酸甘油的FMV和非血流依赖性血管舒张没有差异（平均值分别为16%±9.4%对17.9%±12.4%，以及21.4%±14%对17.8%±11.3%，p>0.05）。未观察到NAFLD组和对照组之间血清ADMA浓度有显著差异（平均值分别为0.8±0.07μmol/L对0.74±0.2μmol/L）。NAFLD组的CVR概况显著高于对照组（平均值分别为9%±6.9%对4.6%±3.8%，P=0.000）。与NAFLD相关的MS显著增加了CVR概况（平均值为11.
