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심혈관계 위험인자로서의 비알코올지방간질환; 경동맥 동맥경화와의 상관관계

Nonalcoholic fatty liver disease as a risk factor of cardiovascular disease; Relation of non-alcoholic fatty liver disease to carotid atherosclerosis

강진화|김영선|박민정|김동희|임선희|김충현|이효석|최수연
대한간학회 (The korean Association for the Study of the Liver)|2008.03|Clinical and Molecular Hepatology|제14권 제1호|pp. 77-88

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Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is closely associated with abdominal obesity, dyslipidemia, hypertension, and Type 2 diabetes, which are all features of the metabolic syndrome. The aim of the present study was to elucidate whether NAFLD is associated with carotid atherosclerosis. Methods: The study population comprised 659 subjects without hepatitis B and C infections and who did not consume alcohol. Fatty infiltrations of liver were detected by abdominal ultrasonography, and intima-media thickness (IMT) and plaque prevalence were estimated by carotid ultrasonography. Results: The mean values of systolic and diastolic pressures, body mass index (BMI), aspartate aminotransferase, alanine aminotransferase, gamma- glutamyl transpeptidase, uric acid, total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, fasting glucose, fasting insulin, homeostasis model of assessment (HOMA) index, hemoglobin A1c, and plasminogen activator inhibitor-1 differed significantly between patients with NAFLD (n=314) and normal controls (n=345). The carotid IMT was 0.817±0.212 (mean±SD) mm in patients with NAFLD and 0.757±0.198 mm in normal controls (p<0.001). The prevalence of carotid plaques was higher in patients with NAFLD (26.4%) than in normal controls (15.9%) (p<0.001). This association persisted significantly after adjusting for age, sex, BMI, HOMA index and individual factors of metabolic syndrome by multiple logistic regression analysis. Conclusions: Patients with NAFLD are at a high risk of carotid atherosclerosis regardless of metabolic syndrome and classical cardiovascular risk factors. Therefore, the detection of NAFLD should alert to the existence of an increased cardiovascular risk. Moreover, NAFLD might be an independent risk factor for cardiovascular disease.

Abstract

Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is closely associated with abdominal obesity, dyslipidemia, hypertension, and Type 2 diabetes, which are all features of the metabolic syndrome. The aim of the present study was to elucidate whether NAFLD is associated with carotid atherosclerosis. Methods: The study population comprised 659 subjects without hepatitis B and C infections and who did not consume alcohol. Fatty infiltrations of liver were detected by abdominal ultrasonography, and intima-media thickness (IMT) and plaque prevalence were estimated by carotid ultrasonography. Results: The mean values of systolic and diastolic pressures, body mass index (BMI), aspartate aminotransferase, alanine aminotransferase, gamma- glutamyl transpeptidase, uric acid, total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, fasting glucose, fasting insulin, homeostasis model of assessment (HOMA) index, hemoglobin A1c, and plasminogen activator inhibitor-1 differed significantly between patients with NAFLD (n=314) and normal controls (n=345). The carotid IMT was 0.817±0.212 (mean±SD) mm in patients with NAFLD and 0.757±0.198 mm in normal controls (p<0.001). The prevalence of carotid plaques was higher in patients with NAFLD (26.4%) than in normal controls (15.9%) (p<0.001). This association persisted significantly after adjusting for age, sex, BMI, HOMA index and individual factors of metabolic syndrome by multiple logistic regression analysis. Conclusions: Patients with NAFLD are at a high risk of carotid atherosclerosis regardless of metabolic syndrome and classical cardiovascular risk factors. Therefore, the detection of NAFLD should alert to the existence of an increased cardiovascular risk. Moreover, NAFLD might be an independent risk factor for cardiovascular disease.

참고문헌 (42)

  1. Adams LA, "Recent concepts in non-alcoholic fatty liver disease", Diabet Med, 22, pp.1129~1133 (2005)
  2. Marchesini G, "Nonalcoholic fatty liver disease and the metabolic syndrome", Curr Opin Lipidol, 16, pp.421~427 (2005)
  3. Angulo P, "Nonalcoholic fatty liver disease", N Engl J Med, 346, pp.1221~1231 (2002)
  4. Eckel RH, "The metabolic syndrome", Lancet, 365, pp.1415~1428 (2005)
  5. McCullough AJ, "Update on nonalcoholic fatty liver disease", J Clin Gastroenterol, 34, pp.255~262 (2002)
  6. Targher G, "Increased prevalence of cardiovascular disease in Type 2 diabetic patients with non-alcoholic fatty liver disease", Diabet Med, 23, pp.403~409 (2006)
  7. Lin YC, "Sonographic fatty liver, overweight and ischemic heart disease", World J Gastroenterol, 11, pp.4838~4842 (2005)
  8. Adams LA, "The natural history of nonalcoholic fatty liver disease: a population-based cohort study", Gastroenterology, 129, pp.113~121 (2005)
  9. Smith SC Jr, "Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: tests for silent and inducible ischemia: Writing Group II", Circulation, 101, pp.E12~16 (2000)
  10. Pearson TA, "New tools for coronary risk assessment: what are their advantages and limitations?", Circulation, 105, pp.886~892 (2002)
  11. Chambless LE, "Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993", Am J Epidemiol, 146, pp.483~494 (1997)
  12. O’Leary DH, "Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults", N Engl J Med, 340, pp.14~22 (1999)
  13. Targher G, "Relation of nonalcoholic hepatic steatosis to early carotid atherosclerosis in healthy men: role of visceral fat accumulation", Diabetes Care, 27, pp.2498~2500 (2004)
  14. Volzke H, "Hepatic steatosis is associated with an increased risk of carotid atherosclerosis", World J Gastroenterol, 11, pp.1848~1853 (2005)
  15. Saadeh S, "The utility of radiological imaging in nonalcoholic fatty liver disease", Gastroenterology, 123, pp.745~750 (2002)
  16. Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)
  17. NCEP, "Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report", Circulation, 106, pp.3143~3421 (2002)
  18. Grundy SM, "Diagnosis and management of the metabolic syndrome", Cardiol Rev, 13, pp.322~327 (2005)
  19. Hollander M, "Carotid plaques increase the risk of stroke and subtypes of cerebral infarction in asymptomatic elderly: the Rotterdam study", Circulation, 105, pp.2872~2877 (2002)
  20. Brea A, "Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: a case-control study", Arterioscler Thromb Vasc Biol, 25, pp.1045~1050 (2005)
  21. Targher G, "Non-alcoholic fatty liver disease, the metabolic syndrome and the risk of cardiovascular disease: the plot thickens", Diabet Med, 24, pp.1~6 (2007)
  22. Villanova N, "Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease", Hepatology, 42, pp.473~480 (2005)
  23. Schindhelm RK, "Liver alanine aminotransferase, insulin resistance and endothelial dysfunction in normotriglyceridaemic subjects with type 2 diabetes mellitus", Eur J Clin Invest, 35, pp.369~374 (2005)
  24. Matteoni CA, "Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity", Gastroenterology, 116, pp.1413~1419 (1999)
  25. Schindhelm RK, "Alanine aminotransferase predicts coronary heart disease events: a 10-year follow- up of the Hoorn Study", Atherosclerosis, 191, pp.391~396 (2007)
  26. Marchesini G, "Nonalcoholic fatty liver disease: a feature of the metabolic syndrome", Diabetes, 50, pp.1844~1850 (2001)
  27. Chitturi S, "NASH and insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome", Hepatology, 35, pp.373~379 (2002)
  28. Haffner SM, "Insulin resistance, inflammation, and the prediabetic state", Am J Cardiol, 92, pp.18J~26J (2003)
  29. Targher G, "Increased plasma markers of inflammation and endothelial dysfunction and their association with microvascular complications in Type 1 diabetic patients without clinically manifest macroangiopathy", Diabet Med, 22, pp.999~1004 (2005)
  30. Yesilova Z, "Systemic markers of lipid peroxidation and antioxidants in patients with nonalcoholic Fatty liver disease", Am J Gastroenterol, 100, pp.850~855 (2005)
  31. Haukeland JW, "Systemic inflammation in nonalcoholic fatty liver disease is characterized by elevated levels of CCL2", J Hepatol, 44, pp.1167~1174 (2006)
  32. Ridker PM, "C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14719 initially healthy American women", Circulation, 107, pp.391~397 (2003)
  33. Ridker PM, "Clinical application of C-reactive protein for cardiovascular disease detection and prevention", Circulation, 107, pp.363~369 (2003)
  34. Hui JM, "Beyond insulin resistance in NASH: TNF-alpha or adiponectin?", Hepatology, 40, pp.46~54 (2004)
  35. Targher G, "Associations between plasma adiponectin concentrations and liver histology in patients with nonalcoholic fatty liver disease", Clin Endocrinol (Oxf), 64, pp.679~683 (2006)
  36. Smith SC Jr, "AHA Conference Proceedings. Prevention conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: executive summary. American Heart Association", Circulation, 101, pp.111~116 (2000)
  37. Hodis HN, "The role of carotid arterial intima-media thickness in predicting clinical coronary events", Ann Intern Med, 128, pp.262~269 (1998)
  38. Lee SK, "The carotid artery intima-media thickness measured with B-mode ultrasonography in adult volunteers", Korean Circ J, 29, pp.1201~1211 (1999)
  39. Bae JH, "Analysis of Korean carotid intima-media thickness in Korean healthy subjects and patients with risk factor: Korea multi-center epidemiological study", Korean Circ J, 35, pp.513~524 (2005)
  40. Zanchetti A, "Systolic and pulse blood pressures (but not diastolic blood pressure and serum cholesterol) are associated with alterations in carotid intima-media thickness in the moderately hypercholesterolaemic hypertensive patients of the Plaque Hypertension Lipid Lowering Italian Study", J Hypertens, 19, pp.79~88 (2001)
  41. Ylitalo K, "Carotid artery intima-media thickness in Finnish families with familial combined hyperlipidemia", Atherosclerosis, 162, pp.171~178 (2002)
  42. Joy D, "Diagnosis of fatty liver disease: is biopsy necessary?", Eur J Gastroenterol Hepatol, 15, pp.539~543 (2003)

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