Nan Hee Kim1, Juri Park2, Seong Hwan Kim3, Yong Hyun Kim3, Dong Hyuk Kim3, Goo-Yeong Cho4, Inkyung Baik5, Hong Euy Lim6, Eung Ju Kim6, Jin Oh Na6, Jung Bok Lee7, Seung Ku Lee8, Chol Shin8. 1. Division of Endocrinology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 2. Division of Endocrinology, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea. 3. Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 4. Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 5. Department of Foods and Nutrition, College of Natural Sciences, Kookmin University, Seoul, Korea. 6. Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea. 7. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea. 8. Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea.
Abstract
OBJECTIVE: The effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular system remains controversial. We investigated the independent contribution of NAFLD to cardiovascular structure and function in the general population. METHODS: A total of 1886 participants without known cardiovascular disease were enrolled from the Korean Genome Epidemiology Study. The participants were divided into four groups, based on the presence of NAFLD, metabolic syndrome (MetS), neither or both. NAFLD was diagnosed by CT. Changes in cardiovascular structure and function were assessed by tissue Doppler imaging (TDI) echocardiography, carotid ultrasound and brachial-ankle pulse wave velocity (baPWV). RESULTS: In multivariate analyses, subjects with both NAFLD and MetS had a higher E/Ea ratio and baPWV, as well as a lower TDI Ea velocity (all p<0.001) than those with neither NAFLD nor MetS. Subjects with either NAFLD or MetS also showed significant differences in TDI Ea velocity and baPWV (all p<0.05). However, no significant differences of carotid intima-media thickness (CIMT) values were seen among the four groups. Multivariate linear regression revealed that both NAFLD and MetS were independent predictors of TDI Ea velocity and baPWV (all p<0.001). Both MetS and NAFLD were not a determinant of CIMT. CONCLUSIONS: NAFLD was associated with early alterations of cardiovascular system, independent of established cardiovascular risk factors and MetS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: The effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular system remains controversial. We investigated the independent contribution of NAFLD to cardiovascular structure and function in the general population. METHODS: A total of 1886 participants without known cardiovascular disease were enrolled from the Korean Genome Epidemiology Study. The participants were divided into four groups, based on the presence of NAFLD, metabolic syndrome (MetS), neither or both. NAFLD was diagnosed by CT. Changes in cardiovascular structure and function were assessed by tissue Doppler imaging (TDI) echocardiography, carotid ultrasound and brachial-ankle pulse wave velocity (baPWV). RESULTS: In multivariate analyses, subjects with both NAFLD and MetS had a higher E/Ea ratio and baPWV, as well as a lower TDI Ea velocity (all p<0.001) than those with neither NAFLD nor MetS. Subjects with either NAFLD or MetS also showed significant differences in TDI Ea velocity and baPWV (all p<0.05). However, no significant differences of carotid intima-media thickness (CIMT) values were seen among the four groups. Multivariate linear regression revealed that both NAFLD and MetS were independent predictors of TDI Ea velocity and baPWV (all p<0.001). Both MetS and NAFLD were not a determinant of CIMT. CONCLUSIONS: NAFLD was associated with early alterations of cardiovascular system, independent of established cardiovascular risk factors and MetS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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