Cattazzo Filippo, Lombardi Rosa, Mantovani Anna, Bevilacqua Michele, Zoncapè Mirko, Iogna Prat Laura, Roccarina Davide, Fortuna Leonardo, Cespiati Annalisa, Sacerdoti David, Fracanzani Anna L, Tsochatzis Emmanouil, Fava Cristiano, Dalbeni Andrea
General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy; Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
Unit of Internal Medicine and Metabolic Disease, Ca' Granda IRCCS Foundation, Policlinico Hospital, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Nutr Metab Cardiovasc Dis. 2022 Dec;32(12):2839-2847. doi: 10.1016/j.numecd.2022.08.005. Epub 2022 Aug 11.
Non-alcoholic fatty liver disease (NAFLD) is associated with increased cardiovascular (CV) risk. However, it is unclear whether NAFLD contributes independently to the development of CV disease. Our study aimed at assessing the differences in several indices of atherosclerosis, arterial stiffness and cardiac morphology among patients with isolated NAFLD, isolated hypertension (HT) or a combination of the two conditions.
A total of 169 participants (mean age = 50.4 ± 10.2 yrs; males = 73.6%) were divided according to the presence of NAFLD and HT into three groups: only NAFLD (55 patients), only HT (49 patients), and NAFLD + HT (65 patients). Exclusion criteria were a BMI≥35 kg/m and a diagnosis of diabetes mellitus. Carotid ultrasonography was performed to measure markers of atherosclerosis and arterial stiffness. Cardiac remodeling was analyzed using echocardiography. The prevalence of subclinical and overt atherosclerosis was significantly higher in the NAFLD + HT patients as compared to the other two groups (atherosclerotic plaques: 43.1%, 10.9%, and 22.4% (p < 0.001) in NAFLD + HT, NAFLD, and HT groups, respectively). No differences were found among indices of arterial stiffening and cardiac remodeling across the three groups. In multivariate regression analysis, the coexistence of NAFLD and HT was an independent risk factor for overt atherosclerosis (OR = 4.88, CI 95% 1.14-20.93), while no association was found when either NAFLD or HT was considered alone.
Overt atherosclerosis was significantly present only in NAFLD + HT patients, but not in patients with isolated NAFLD. This implies that the impact of NAFLD on vascular structure and function could depend on the coexistence of other major CV risk factors, such as HT.
非酒精性脂肪性肝病（NAFLD）与心血管（CV）风险增加相关。然而，尚不清楚NAFLD是否独立促成心血管疾病的发生。我们的研究旨在评估单纯NAFLD、单纯高血压（HT）或两者合并的患者在动脉粥样硬化、动脉僵硬度和心脏形态的几个指标上的差异。
根据是否存在NAFLD和HT，将总共169名参与者（平均年龄 = 50.4 ± 10.2岁；男性 = 73.6%）分为三组：仅NAFLD（55例患者）、仅HT（49例患者）和NAFLD + HT（65例患者）。排除标准为BMI≥35kg/m以及糖尿病诊断。进行颈动脉超声检查以测量动脉粥样硬化和动脉僵硬度的标志物。使用超声心动图分析心脏重塑。与其他两组相比，NAFLD + HT患者中亚临床和显性动脉粥样硬化的患病率显著更高（动脉粥样硬化斑块：NAFLD + HT组、NAFLD组和HT组分别为43.1%、10.9%和22.4%（p < 0.001））。三组之间在动脉僵硬度和心脏重塑指标上未发现差异。在多变量回归分析中，NAFLD和HT共存是显性动脉粥样硬化的独立危险因素（OR = 4.88，95%CI 1.14 - 20.93），而单独考虑NAFLD或HT时未发现关联。
显性动脉粥样硬化仅在NAFLD + HT患者中显著存在，而在单纯NAFLD患者中不存在。这意味着NAFLD对血管结构和功能的影响可能取决于其他主要CV危险因素如HT的共存情况。
