Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10192-10199
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10192
Correlation between non-alcoholic fatty liver with metabolic risk factors and brachial-ankle pulse wave velocity
Wen-Hua Zhu, Li-Zheng Fang, Chong-Rong Lu, Hong-Lei Dai, Jian-Hua Chen, Qiao-Hua Qiao, Li-Ying Chen
Wen-Hua Zhu, Li-Zheng Fang, Chong-Rong Lu, Hong-Lei Dai, Jian-Hua Chen, Qiao-Hua Qiao, Li-Ying Chen, Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Zhu WH, Chen LY and Fang LZ designed the research and analyzed the data; Lu CR and Dai HL evaluated non-alcoholic fatty liver and brachial-ankle pulse wave velocity; Chen JH and Qiao QH collected and collated data.
Supported by Grants from Public Interest Research and Social Development Program of Zhejiang Province, No. 2011C23098; Biomedical Science and Technology Foundation of Zhejiang Province, No. 2012B20123; and Education bureau of Zhejiang Province, China, No. Y201223481.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Sir Run Run Shaw Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Li-Ying Chen, MD, Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine, Zhejiang University, No. 3 Qingchun Donglu, Hangzhou 310016, Zhejiang Province, China. cly0906@163.com
Telephone: +86-571-86006667 Fax: +86-571-86044820
Received: March 1, 2015
Peer-review started: March 2, 2015
First decision: April 23, 2015
Revised: May 18, 2015
Accepted: July 15, 2015
Article in press: July 15, 2015
Published online: September 21, 2015
Processing time: 200 Days and 13 Hours
Abstract

AIM: To assess the relationship between non-alcoholic fatty liver disease (NAFLD) with metabolic risk factors and brachial ankle pulse wave velocity (baPWV).

METHODS: A total of 8603 subjects (6662 males and 1941 females) were enrolled during an annual health check-up. Fatty liver was examined using a Philips HD 11 XE multi-function color Doppler diagnostic instrument, and baPWV was determined using a novel arteriosclerosis detection device. Blood pressure (BP), fasting plasma glucose (FPG), waist circumference (WC), plasma triglycerides (TG), high-density lipoprotein (HDL), total cholesterol (TC), low-density lipoprotein (LDL) and uric acid (UA) were measured using standard methods. The relationship between fatty liver with metabolic risk factors and baPWV was analyzed using regression analysis and the χ2 test.

RESULTS: The values and abnormal rates of baPWV were significantly different between NAFLD patients and non-NAFLD subjects (P < 0.001). In addition, the values of baPWV were different by gender between NAFLD patients and non-NAFLD subjects. The OR values in females, males, and the entire population were 3.33, 1.67, and 2.13, respectively (P < 0.001). The incidence of high baPWV increased with increasing degree of NAFLD (levels 0, 1, 2, and 3) (P < 0.001), which was 45.9%, 54.5%, 60.2%, and 71.4% in males and 27.0%, 49.1%, 55.60%, and 60.0% in females (P < 0.001), respectively. Logistic regression analysis showed that the OR value for baPWV in the non-metabolic syndrome group and the metabolic syndrome group was 1.28 vs 1.14 (males) and 2.55 vs 0.98 (females). The OR values for baPWV in the non-high-BP and high-BP, non-high-WC and high-WC, non-high-FPG and high-FPG, non-high-TG and high-TG, non-high-HDL and high-HDL, non-high-TC and high-TC, non-high-LDL and high-LDL, non-high-UA and high-UA groups were 3.38 vs 1.19, 3.50 vs 1.44, 2.80 vs 2.30, 3.29 vs 1.88, 3.03 vs 3.28, 3.35 vs 2.70, 3.93 vs 1.66, and 3.20 vs 2.34, respectively, in females (P < 0.001), and were 1.37 vs 1.34, 1.56 vs 1.26, 1.51 vs 1.28, 1.49 vs 1.52, 1.71 vs 1.61, 1.59 vs 1.74, 1.76 vs 1.47, and 1.73 vs 1.54, respectively, in males (P < 0.01). The OR value for baPWV was still higher than 1.2 (1.21 in males and 1.40 in females) after adjustment for the metabolic component (0, 1, 2, 3, 4, 5, 6 and above) (P < 0.01).

CONCLUSION: NAFLD is closely correlated with baPWV, particularly in females. NAFLD has a large impact on baPWV, no matter whether the metabolic index is increased or not. NAFLD may be a useful indicator for assessing early arteriosclerosis.

Keywords: Non-alcoholic fatty liver; Metabolic risk factors; Brachial ankle pulse wave velocity

Core tip: Non-alcoholic fatty liver disease (NAFLD) is emerging as an independent risk factor for the occurrence and progression of ischemic cardiovascular disease. However, the association between NAFLD and arterial stiffness is not fully elucidated. This study showed that NAFLD is closely related to brachial ankle pulse wave velocity. NAFLD has a noticeable impact when considering gender in the metabolic risk factor group, especially in females. NAFLD may be a useful indicator for assessing early arteriosclerosis.