scholarly journals Ambulatory blood pressure variability measures in hypertensive patients according to non-alcoholic fatty liver disease state

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Kakouri ◽  
D Konstantinidis ◽  
E Siafi ◽  
F Tatakis ◽  
D Polyzos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Liver Disease ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Blood Pressure Variability ◽  
Alcoholic Fatty Liver ◽  
Hypertensive Patients

Abstract Background Nonalcoholic fatty liver disease (NAFLD) represents the most frequent cause of chronic hepatic disease and independently determines hypertension and future cardiovascular events. Increased blood pressure variability (BPV) assessed by 24-hour blood pressure (BP) monitoring including mean arterial morning surge have been also associated with increased rates of cardiovascular events. Purpose To compare different BPV measures in hypertensive patients with and without NAFLD. Methods Consecutive newly diagnosed untreated hypertensive patients without history of cardiovascular disease underwent clinic and ambulatory BP measurements. NAFLD was diagnosed by liver ultrasound to separate patients into those with and without NAFLD. BPV was derived by assessment of standard deviation (SD) of systolic and diastolic BP (24-h, daytime and nighttime), average real variability (ARV) of systolic and diastolic BP, coefficient of variation (CV) of systolic BP (24-h, daytime), weighted SD (wSD) of systolic BP (24-h, daytime), maximum BP and mean arterial morning surge. Results Among 146 hypertensive patients (mean age 57±11 years, 64 men, 24-h mean systolic/diastolic BP 140±10/84±9 mmHg) those with NAFLD (n=76) compared to the non-NAFLD group (n=70) were younger (54.7±10.1 vs 58.6±11.2 years, respectively, p=0.03), male gender was more prevalent (42 vs 22 respectively, p=0.004), and body mass index was more increased (33.2±4.1 vs 27.0±3.5 kg/m2, p<0.001). Moreover, NAFLD patients compared to those without NAFLD were characterized by higher levels of mean arterial pressure morning surge (12.4±8.9 vs 8.7±8.5 mmHg, p=0.03), but the remaining BPV measures were not different between the two groups. NAFLD was a determinant of both diastolic BP ARV (B=0.34, p=0.007) and mean arterial morning surge (B=0.47, p=0.006) after adjustment. Conclusions Mean arterial pressure morning surge was significantly higher in hypertensive patients with NAFLD compared to their non-NAFLD counterparts, while whole day BPV measures were not increased in NAFLD except for ARV of diastolic BP. Our findings may partially explain the increased cardiovascular risk of comorbid NAFLD in hypertension. FUNDunding Acknowledgement Type of funding sources: None.

Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort

Gut ◽  
2021 ◽  
pp. gutjnl-2021-325724
Author(s):  
Tracey G Simon ◽  
Bjorn Roelstraete ◽  
Hannes Hagström ◽  
Johan Sundström ◽  
Jonas F Ludvigsson
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Major Adverse Cardiovascular Events ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Population Controls

ObjectiveSome data suggest a positive association between non-alcoholic fatty liver disease (NAFLD) and incident major adverse cardiovascular events (MACEs). However, data are lacking from large cohorts with liver histology, which remains the gold standard for staging NAFLD severity.DesignThis population-based cohort included all Swedish adults with histologically confirmed NAFLD and without cardiovascular disease (CVD) at baseline (1966–2016, n=10 422). NAFLD was defined from prospectively recorded histopathology and categorised as simple steatosis, non-fibrotic steatohepatitis, non-cirrhotic fibrosis and cirrhosis. Patients with NAFLD were matched to ≤5 population controls without NAFLD or CVD, by age, sex, calendar year and county (n=46 517). Using Cox proportional hazards modelling, we calculated multivariable adjusted HRs (aHRs) and 95% CIs for MACE outcomes (ie, ischaemic heart disease (IHD), stroke, congestive heart failure (CHF) or cardiovascular (CV) mortality).ResultsOver a median of 13.6 years, incident MACE was confirmed in 2850 patients with NAFLD and 10 648 controls. Patients with NAFLD had higher incidence of MACE than controls (24.3 vs 16.0/1000 person-years (PY); difference=8.3/1000 PY; aHR 1.63, 95% CI 1.56 to 1.70), including higher rates of IHD (difference=4.2/1000 PY; aHR 1.64, 95% CI 1.54 to 1.75), CHF (difference=3.3/1000 PY; aHR 1.75, 95% CI 1.63 to 1.87), stroke (difference=2.4/1000 PY; aHR 1.58, 95% CI 1.46 to 1.71) and CV mortality (difference=1.2/1000 PY; aHR 1.37, 95% CI 1.27 to 1.48). Rates of incident MACE increased progressively with worsening NAFLD severity (ptrend=0.02), with the highest incidence observed with cirrhosis (difference vs controls=27.2/1000 PY; aHR 2.15, 95% CI 1.77 to 2.61).ConclusionCompared with matched population controls, patients with biopsy-proven NAFLD had significantly higher incidence of MACE, including IHD, stroke, CHF and CV mortality. Excess risk was evident across all stages of NAFLD and increased with worsening disease severity.

scholarly journals Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications

2019 ◽  
Vol 16 (17) ◽  
pp. 3104 ◽  
Author(s):  
Claudio Tana ◽  
Stefano Ballestri ◽  
Fabrizio Ricci ◽  
Angelo Di Vincenzo ◽  
Andrea Ticinesi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level rise of NAFLD—in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome—and its association with poor cardiovascular outcomes, the question of how to manage NAFLD properly, in order to reduce the burden of associated incident cardiovascular events, is both timely and highly relevant. This review aims to summarize the current knowledge of the association between NAFLD and cardiovascular disease, and also to discuss possible clinical strategies for cardiovascular risk assessment, as well as the spectrum of available therapeutic strategies for the prevention and treatment of NAFLD and its downstream events.

scholarly journals Association of Non-Alcoholic Fatty Liver Disease with Metabolic Syndrome: A Single Center Study

2022 ◽  
Vol 8 (1) ◽  
pp. 310-317
Author(s):  
Debasish Dutta
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Waist Circumference ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
College Hospital ◽  
Alcoholic Fatty Liver ◽  
Grade Ii ◽  
Alcoholic Fatty Liver Disease

Background: NAFLD is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver (> 5% of hepatocytes histologically). Non-alcoholic fatty liver disease is increasingly being recognized as a major cause of liver-related morbidity and mortality among 15-40% of the general population. Aim of the study: To evaluate the clinical profile of patients with non-alcoholic fatty liver disease and its association with metabolic syndrome.Methods:The present cross-sectional, retro-spective study was conducted as outdoor patient basis in the Department of Medicine, Jashore medical college hospital & a private diagnostic centre, Jashore.. A total of 74 cases were included for the study. All patients in the study underwent routine investigations including complete blood counts, blood sugar, liver function tests, HBsAg, anti-HCV, lipid profile andUSG of whole abdomen. The data was collected during OPD treatment and was recorded in predesigned and pretested proforma and analyzed.Results:Mean age of the patient was 53.70±7.22 years. On physical examination findings showed the mean BMI was 27.6±4.39 kg/m2, mean waist circumference was 74.22±7.44 cm. Mean diastolic blood pressure (mm Hg) was 92.87±6.25 and mean systolic blood pressure (mm Hg) 132.0±18.17. Maximum 52% patients had triglycerides >150 mg/dl while low serum HDL level was seen in 37% patients and increased waist circumference was found in 32% patients. Altered ALT ≥41 IU was observed in 10 (62.50%) of Grade II of patients with NAFLD with metabolic syndrome. Central obesity was observed in 12 (75.00%) of Grade II patients with NAFLD with metabolic syndrome. While 14 (87.50%) Grade II of patients with NAFLD with metabolic syndrome showed impaired fasting glucose (>110 mg/dl). Hypertriglyceridemia (>150 mg/dl) in 12 (70.58%) seen in Grade I of patients with NAFLD without metabolic syndrome.Conclusion:Higher prevalence of all the components of metabolic syndrome in cases of NAFLD was observed. It can be concluded that symptoms and signs of NAFLD are non-specific and occur later in the course of the disease hence the physician should have a high index of suspicion in order to detect NAFLD early in the course of the disease.

scholarly journals Association Between Hepatic Steatosis and Metabolic Syndrome in Patients With Non-alcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 858-858
Author(s):  
Victoria Quadros Pereira ◽  
Carine Panke ◽  
Leticia Eifler ◽  
Cristiane Tovo ◽  
Thaís Moreira
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Serum Triglycerides ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Objectives Evaluate the association between the degree of hepatic steatosis and the development of metabolic syndrome in outpatients care. Methods Prospective cross-sectional study with outpatients care at the Gastroenterology Service of a hospital in southern Brazil. The study was approved by the Ethics Committee with protocol 57,328,416.8.0000.5335. Patients aged over 18 years and with non-alcoholic fatty liver disease were included. Patients were excluded from hepatitis B and C, with significant alcohol consumption and hepatocellular carcinoma. Data collection occurred during nutritional consultations, where we collected data of age, gender, lifestyle, diagnosis of comorbidities and biochemical tests. The result of liver biopsy was evaluated for the degree of hepatic steatosis. Anthropometric parameters were assessed for the diagnosis of metabolic syndrome, in addition to electrical bioimpedance for body composition. Data were presented as mean, median, standard deviation, interquartile range and percentages according to distribution. Student T, ANOVA and Pearson correlation tests were applied. The significance level was 5%. Results We evaluated 71 patients with mean age 59.08 ± 8.92 years, 67.6% (n = 48) women, 60.6% (n = 43) sedentary, 52.2% (n = 37) no smoking and mean body mass index of 32.91 ± 5.27 kg/m2. Systemic arterial hypertension were diagnosed in 80.3% (n = 57), 73.2% (n = 52) were diabetic, 66.2% (n = 47) were dyslipidemic and 28.2% (n = 20) of patients with metabolic syndrome. As liver biopsy, 25.4% (n = 18) mild steatosis, 23.9% (n = 17) moderate and 26.8% (n = 19) intense. In the comparison between the levels of hepatic steatosis and the variables, it was observed that patients with severe steatosis had metabolic syndrome (p = 0.041). Patients with metabolic syndrome have higher fat mass (p = 0.044), diastolic blood pressure (p = 0.019) and higher levels of serum triglycerides (p = 0.043). Severe hepatic steatosis correlated with the diagnosis of metabolic syndrome (r = 0.319; p = 0.019). Conclusions Severe hepatic steatosis is related to the diagnosis of metabolic syndrome.Patients with metabolic syndrome had a higher amount of fat mass, increased diastolic blood pressure and serum triglycerides. Funding Sources This study was not funded.

scholarly journals Colonic Diverticulosis and Non-Alcoholic Fatty Liver Disease: Is There a Connection?

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 38
Author(s):  
Ivana Pantic ◽  
Sofija Lugonja ◽  
Nina Rajovic ◽  
Igor Dumic ◽  
Tamara Milovanovic
Keyword(s):  
Blood Pressure ◽  
Liver Disease ◽  
Fatty Liver ◽  
Total Cholesterol ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Colonic Surgery ◽  
Colonic Diverticulosis ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background and Objectives: The development and severity of colonic diverticulosis and non-alcoholic fatty liver disease (NAFLD) has been associated with several components of metabolic syndrome (MetS). Therefore, this study aimed to evaluate a possible connection between NAFLD, colonic diverticulosis, and MetS. Materials and Methods: This retrospective study included patients diagnosed with diverticulosis between January 2017 and December 2019. Data regarding the patient demographics, Diverticular Inflammation and Complication Assessment (DICA) score and category, disease localization, hepatic steatosis, blood pressure, comprehensive metabolic panel, need for colonic surgery, and co-morbidities were collected from medical records. Results: A total of 407 patients with a median age of 68 years (range, 34–89 years) were included (male: 53.81%). The majority was diagnosed with left-sided diverticulosis (n = 367, 90.17%) and an uncomplicated disease course (DICA category 1, n = 347, 85.3%). Concomitant hepatic steatosis was detected in 47.42% (n = 193) of patients. The systolic blood pressure, triglycerides, total cholesterol, C-reactive protein (CRP), and fasting glucose were higher in the NAFLD group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively). A higher prevalence of hypertension (HTA), type 2 diabetes mellitus (T2DM), and hypothyroidism was noted in the same group of patients (p < 0.001, p < 0.001, and p = 0.008, respectively). High-density lipoprotein cholesterol was lower in patients with more severe forms of diverticulosis (DICA category 2 and 3), while CRP levels were significantly higher (p = 0.006 and p = 0.015, respectively). HTA and NAFLD were more common in patients with more severe forms of colonic diverticulosis (p = 0.016 and p = 0.025, respectively). Using a multivariate logistic regression, the DICA score, CRP, total cholesterol, HTA, and hypothyroidism were identified as discriminating factors for the presence of hepatic steatosis. Conclusion: Components of metabolic dysregulation were prominent in patients diagnosed with colonic diverticulosis and concomitant hepatic steatosis. HTA, T2DM, and hypothyroidism were more frequently observed in this group. Hepatic steatosis was more commonly detected in more severe forms of colonic diverticulosis.

Sign in / Sign up

Export Citation Format

Share Document