Non-alcoholic fatty liver disease as an unaccounted risk factor for atherosclerosis
.
Research Institute of Clinical Cardiology «National Medical Research Center Of Cardiology», Moscow
A review is devoted to the interrelation between atherosclerosis and non-alcoholic fatty liver disease (NAFLD). NAFLD is considered as a hepatic manifestation and a metabolic syndrome. The article provides data confirming the role of NAFLD as an independent predictor of the atherosclerotic vascular disease and an increase of vascular stiffness, in particular in patients with low cardiovascular risk. Possible common mechanisms of pathogenesis of these two diseases are considered. The article confirms the need to assess the state of the vascular wall in NAFLD patients without diagnosed cardiovascular diseases (CVD) for taking prompt measures to prevent cardiovascular complications. The preventive measures should include first of all such universal methods as a proper diet, sufficient physical activity and normalization of body weight. The research conducted by The Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) showed that administration of statins reduces not only cardiovascular risk, but also the risk of complications of NAFLD. The role of hepatoprotectors in the therapy of dyslipidemia in patients with NAFLD is considered. So it is advisable to use essential phospholipids, for example Essentiale® forte N, to normalize the blood lipids, parameters of lipid peroxidation and antioxidant support network.
Key words: non-alcoholic fatty liver disease, atherosclerosis, vascular wall, hepatoprotectors, Essentiale® forte N.
For citation: Smirnova M.D. Non-alcoholic fatty liver disease as an unaccounted risk factor for atherosclerosis // RMJ. Medical Review. 2018. № 4. P. 8–11.
References
1. Browning J. et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity // Hepatology. 2004. Vol. 40. P.1387–1395.
2. Clark J.M. et al. The prevalence and etiology of elevated aminotransferase levels in the United States // Am J Gastroenterol. 2003. Vol. 98. P. 960–967.
3. Ивашкин В.Т., Драпкина О.М., Шульпекова Ю.О. Диагностика и лечение неалкогольной жировой болезни печени: Метод. рекомендации. М.: М-Вести. 2009. 20 с. [Ivashkin V.T., Drapkina O.M., Shul’pekova Ju.O. Diagnostika i lechenie nealkogol’noj zhirovoj bolezni pecheni: Metod. rekomendacii. M.: M-Vesti. 2009. 20 s. (in Russian)].
4. Reusch J.E. Current concepts in insulin resistance, type 2 diabetes mellitus, and the metabolic syndrome // Am. J. Cardiol. 2002. Vol. 90 (5). P. 19–26.
5. Brunzell J.D., Hokanson J.E. Dyslipidemia of central obesity and insulin resistance // Diabetes Care. 1999. Vol. 22. Suppl. 3. P. 10–13.
6. Armstrong M.J., Houlihan D.D., Bentham L. et al. Presence and severity of non-alcoholic fatty liver disease in a large prospective primary care cohort // J. Hepatol. 2012. Vol. 56(1). P. 234–240.
7. Kucukazman M., Ata N., Yavuz B. et al. Evaluation of early atherosclerosis markers in patients with nonalcoholic fatty liver disease // Eur J Gastroenterol Hepatol. 2013. Vol. 25(2). P. 147–151.
8. Kotronen A., Yki-Jarvinen H. Fatty liver: a novel component of the metabolic syndrome // Arterioscler Thromb Vasc Biol. 2008. Vol. 28(1). P. 27–38. doi: 10.1161/ATVBAHA.107.147538
9. Lonardo A., Ballestri S., Marchesini G. et al. Nonalcoholic fatty liver disease: a precursor of the metabolic syndrome // Dig Liver Dis. 2015. Vol. 47(3). P. 181–190. doi: 10.1016/j.dld.2014.09.020
10. Hamaguchi M., Kojima T., Takeda N. et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease // Ann Intern Med. 2005. Vol. 143. P. 722–728.
11. Marchesini G., Brizi M., Bianchi G. et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome // Diabetes. 2001. Vol. 50. P. 1844–1850.
12. Драпкина О.М., Ивашкин В.Т. Эпидемиологические особенности неалкогольной жировой болезни печени в России (результаты открытого многоцентрового проспективного исследования-наблюдения DIREGL 01903) // Рос журн гастроэнтерол, гепатол, колопроктол. 2014. № 24(4). С. 32–38 [Drapkina O.M., Ivashkin V.T. Jepidemiologicheskie osobennosti nealkogol’noj zhirovoj bolezni pecheni v Rossii (rezul’taty otkrytogo nogocentrovogo prospektivnogo issledovanija-nabljudenija DIREGL 01903) // Ros zhurn gastrojenterol, gepatol, koloproktol. 2014. № 24( 4). S. 32–38 (in Russian)].
13. Targher G., Bertolini L., Padovani R. et al. Relation of nonalcoholic hepatic steatosis to early carotid atherosclerosis in healthy men: role of visceral fat accumulation // Diabetes Care. 2004. Vol. 27. P. 2498–2500.
14. Brea A., Mosquera D., Martín E., et al. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: a case-control study // Arterioscler Thromb Vasc Biol. 2005. Vol. 25. P. 1045–1050.
15. Targher G., Bertolini L., Padovani R. et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease // Diabetes Care. 2006. Vol. 29. P. 1325–1330.
16. Aygun C., Kocaman O., Sahin T. et al. Evaluation of metabolic syndrome frequency and carotid artery intima-media thickness as risk factors for atherosclerosis in patients with nonalcoholic fatty liver disease // Dig Dis Sci. 2008. Vol. 53. P. 1352–1357.
17. Kim H.C., Kim D.J., Huh K.B. Association between nonalcoholic fatty liver disease and carotid intimamedia thickness according to the presence of metabolic syndrome // Atherosclerosis. 2009. Vol. 204. P. 521–525.
18. S. Ramilli, S. Pretolani, A. Muscari et al. Carotid lesions in outpatients with nonalcoholic fatty liver disease Carotid lesions in outpatients with nonalcoholic fatty liver disease // World J Gastroenterol. 2009. Vol. 15(38). P. 4770–4774. doi: 10.3748/wjg.15.4770
19. Chung G.E., Choi S.-Y., Kim D. et al. Nonalcoholic Fatty Liver Disease as a Risk Factor of Arterial Stiffness Measured by the Cardioankle Vascular Index // Medicine (Baltimore). 2015. Vol. 94(12). P. 654. doi: 0.1097/MD.0000000000000654
20. Li N., Zhang G.W., Zhang J.R. et al. Non-alcoholic fatty liver disease is associated with progression of arterial stiffness // Nutr Metab Cardiovasc Dis. 2015. Vol. 25(2). P. 218–223. doi: 10.1016/j.numecd.2014.10.002
21. Li X., Shi H., Wang Z. et al. Arterial stiffness is increased in nondiabetic, nonhypertensive postmenopausal women with nonalcoholic fatty liver disease // J Hypertens. 2017. Vol. 35(6). P. 1226–1234.
22. Ozturk K., Uygun A., Guler A.K. et al . Nonalcoholic fatty liver disease is an independent risk factor for atherosclerosis in young adult men // Atherosclerosis. 2015. Vol. 240(2). P. 380–386. doi: 10.1016/j.atherosclerosis.2015.04.009.
23. Chen Y., Xu M., Wang T. et al. Advanced fibrosis associates with atherosclerosis in subjects with nonalcoholic fatty liver disease // Atherosclerosis. 2015. Vol. 241(1). P. 145–150. doi: 10.1016
24. Wang C.C., Lin S.K., Tseng Y.F. et al. Elevation of serum aminotransferase activity increases risk of carotid atherosclerosis in patients with non-alcoholic fatty liver disease // J Gastroenterol Hepatol. 2009. Vol. 24(8). P. 1411–1416. doi: 10.1111/j.1440-1746.2009.05872.
25. Kim K.S., Oh H.J., Kim D.J. et al. The association between non-alcoholic fatty liver disease and carotid atherosclerosis in subjects with within-reference range alanine aminotransferase levels // Endocr J. 2013. Vol. 60(12). P. 1295–1301.
26. Leite N.C., Villela-Nogueira C.A., Ferreira M.T. et al. Increasing aortic stiffness is predictive of advanced liver fibrosis in patients with type 2 diabetes: the Rio-T2DM cohort study // Liver Int. 2016. Vol. 36(7). P. 977–985. doi: 10.1111/liv.12994
27. Kim S.K., Choi Y.J., Huh B.W. et al. Nonalcoholic Fatty liver disease is associated with increased carotid intima-media thickness only in type 2 diabetic subjects with insulin resistance // J Clin Endocrinol Metab. 2014. Vol. 99(5). P. 1879–1884. doi: 10.1210/jc.2013-4133
28. Звенигородская Л.А., Черкашова Е.А., Нилова Т.В. Гиполипидемическая терапия у больных с неалкогольной жировой болезнью печени // Эффективная фармакотерапия. 2012. № 4. С. 22–31 [Zvenigorodskaja L.A., Cherkashova E.A., Nilova T.V. Gipolipidemicheskaja terapija u bol’nyh s nealkogol’noj zhirovoj bolezn’ju pecheni // Jeffektivnaja farmakoterapija. 2012. № 4. S. 22–31 (in Russian)].
29. Драпкина О.М., Фадеева М. Атеросклероз — болезнь печени? // Справочник поликлинического врача. 2013. № 10. С. 4–9 [Drapkina O.M., Fadeeva M. Ateroskleroz — bolezn’ pecheni? // Spravochnik poliklinicheskogo vracha. 2013. № 10. S. 4–9 (in Russian)].
30. Athyros V.G., Tziomalos K., Gossios T.D. et al. GREACE Study Collaborative Group Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysi // The Lancet. 2010. Vol. 4 (10). P. 1916–1922.
31. Gonciarz Z., Besser P., Lelek E. et al. Randomised placebo-controlled doubleblind trial on essential phospholipids in the treatment of fatty liver associated with diabetes // Med Chir Dig. 1988. Vol. 17(1). P. 61–65.
32. Sas E., Grinevich V., Efimov O. et al Beneficial influence of polyunsaturated Phosphatidylcholine enhances functional liver condition and liver structure in patients with Nonalcoholic steatohepatitis. Results of prolonged randomized blinded prospective clinical study // J Hepatol. 2013. Vol. 58. P. 549.
33. Dajani Al., Abu Hammour A.M., Zakaria M.A. et al. EPL in the management of primary NAFLD and NAFLD associated with co-morbid disease // Hepatol Int. 2013. Vol. 7. Suppl. 1. P. 108.
34. Un C., Zheng X., Tan Z. et al. Clinical Observation on Polyene Phosphatidyl Choline and Metformin in the Treatment of Type 2 Diabetes and Non-alcoholic Fatty Liver Disease // Clin Focus. 2008. Vol. 23(17). P. 1272–1273.
35. Yin Kong. Observation for curative effect of Essentiale in treatment of fatty liver caused by diabetes mellitus // Med J Q ilu. 2000. Vol. 15. P. 277–278.
36. Palgova L., Tarasova M., Borisova I. The influence of high level of aminotransferase on pregnancy and delivery.Abstracts of APASL Liver Week // Hepatology International. 2015. Vol.7. P. 106–107.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
