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. 2016 Mar 26;17(4):456.
doi: 10.3390/ijms17040456.

Additive Effect of Non-Alcoholic Fatty Liver Disease on Metabolic Syndrome-Related Endothelial Dysfunction in Hypertensive Patients

Maria Perticone  1 , Antonio Cimellaro  2 , Raffaele Maio  3 , Benedetto Caroleo  4 , Angela Sciacqua  5 , Giorgio Sesti  6 , Francesco Perticone  7
Affiliations

Additive Effect of Non-Alcoholic Fatty Liver Disease on Metabolic Syndrome-Related Endothelial Dysfunction in Hypertensive Patients

Maria Perticone et al. Int J Mol Sci. .

Abstract

Metabolic syndrome (MS) is characterized by an increased risk of incident diabetes and cardiovascular (CV) events, identifying insulin resistance (IR) and endothelial dysfunction as key elements. Moreover, non-alcoholic fatty liver disease (NAFLD) is bidirectionally linked with MS as a consequence of metabolic and inflammatory abnormalities. We addressed the question if the evolution in NAFLD might worsen endothelium-dependent vasodilating response in MS hypertensives. We recruited 272 Caucasian newly-diagnosed never-treated hypertensive outpatients divided into three groups according to the presence/absence of MS alone or in combination with NAFLD. MS and NAFLD were defined according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and non-invasive fatty liver index, respectively. We determined IR by using the homeostasis model assessment (HOMA) index. Vascular function, as forearm blood flow (FBF), was determined through strain-gauge plethysmography after intra-arterial infusion of acetylcholine (ACh) and sodium nitroprusside. MS+NAFLD+ group showed worse metabolic, inflammatory and vascular profiles compared with MS-NAFLD- and MS+NAFLD-. HOMA resulted in being the strongest predictor of FBF both in the MS+NAFLD- and in the MS+NAFLD+ groups, accounting for 20.5% and 33.2% of its variation, respectively. In conclusion, we demonstrated that MS+NAFLD+ hypertensives show a worse endothelium-dependent vasodilation compared with MS+NAFLD-, allowing for consideration of NAFLD as an early marker of endothelial dysfunction in hypertensives.

Keywords: arterial hypertension; cardiovascular disease and risk; endothelial dysfunction; metabolic syndrome; non-alcoholic fatty liver disease.

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Figures

Figure 1
Figure 1
Responses of forearm blood flow (FBF) to intra-arterial infusions of acetylcholine (ACh) and sodium nitroprusside (SNP) in different groups.
Figure 2
Figure 2
Graphic report of the logistic regression analysis for decreased forearm blood flow.
See this image and copyright information in PMC

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