Effects of liver function, insulin resistance and inflammatory factors on vascular endothelial dilation function and prognosis of coronary heart disease patients complicated with NAFLD

Abstract

Effects of liver function, insulin resistance (IR) and inflammatory factors on vascular endothelial dilation function and prognosis of coronary heart disease (CHD) patients complicated with non-alcoholic fatty liver disease (NAFLD) were investigated. A total of 80 patients with CHD treated in Jinan Central Hospital from October 2016 to July 2017 were randomly enrolled and divided into the NAFLD group (n=41) and the simple CHD group (n=39). The IR, the vascular endothelial dilation function and the related inflammatory factors were also detected, followed by statistical analysis. The level of high-sensitivity C-reactive protein (hs-CRP), serum total bilirubin and alanine aminotransferase (ALT) levels and body mass index in the NAFLD group was decreased and the expression of tumor necrosis factor-α was increased compared with that in the simple CHD group (P<0.05). There was a linearly positive correlation between ALT and brachial artery diameter in the NAFLD group (r=0.311, P<0.05). There was a correlation between homeostasis model assessment-IR (HOMA-IR) and HOMA-β indexes and brachial artery diameter, hs-CRP and brachial artery diameter in both groups (r=-0.128, r=0.219, P<0.05). The HOMA indexes in the NAFLD group were increased compared with those in the simple CHD group (P<0.01). There were significant differences in the intima-media thickness, number of carotid plaques and detection rate of carotid plaques (P<0.05). The risk of cardiovascular events within 10 years in the NAFLD group was increased compared with that in the simple CHD group. The differences of incidence of cardiovascular diseases (CVD)s were statistically significant (P<0.05). Therefore, The changes in liver function indexes, IR and related inflammatory factors in CHD patients complicated with NAFLD significantly affect the vascular endothelial dilation function, which also have some effects on the occurrence of CVDs.

Keywords: coronary heart disease; inflammatory factors; insulin resistance; nonalcoholic fatty liver disease.

Figure 1.

Comparison of serum TNF-α and hs-CRP between the groups. TNF-α, tumor necrosis factor-α; hs-CRP, high-sensitivity C-reactive protein; CHD, coronary heart disease; NAFLD, non-alcoholic fatty liver disease. *P<0.05.

Figure 2.

Comparison of general conditions and liver function between the two groups: (A-C) the serum TBIL and ALT levels and BMI in the NAFLD group were significantly higher than those in the simple CHD group, and the differences were statistically significant (*P<0.05). (D) There was no statistically significant difference in the serum AST level between the two groups (P>0.05). TBIL, total bilirubin; ALT, alanine aminotransferase; BMI, body mass index; NAFLD, non-alcoholic fatty liver disease; CHD, coronary heart disease; AST, aspartate aminotransferase.

Figure 3.

(A) Correlation analysis between serum ALT and brachial artery diameter in the NAFLD group showed that there was a statistically significant difference (r=0.311, P<0.05). (B and C) There was a statistically significant difference in the correlation between HOMA-IR and HOMA-β indexes and brachial artery diameter in both groups (r=−0.128, r=0.219, P<0.05). (D and E) There was a statistically significant difference in the correlation between hs-CRP and brachial artery diameter in both groups (r=−0.312, P<0.05); TNF-α had no correlation with brachial artery diameter, and the difference was not statistically significant (r=3.286, P>0.05). ALT, alanine aminotransferase; NAFLD, non-alcoholic fatty liver disease; HOMA-IR, homeostasis model assessment-insulin resistance; hs-CRP, high-sensitivity C-reactive protein; TNF-α, tumor necrosis factor-α.

Figure 4.

Correlation between serum NO and ALT levels. NO, nitric oxide; ALT, alanine aminotransferase.