Markers of endothelial dysfunction in patients with non-alcoholic fatty liver disease and coronary artery disease
Markers of endothelial dysfunction in patients with non-alcoholic fatty liver disease and coronary artery disease
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DOI：
10.1111/jgh.12549
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发表时间：
2014-07-01
影响因子：
4.1
通讯作者：
Younossi, Zobair M.
中科院分区：
文献类型：
--
作者：
Elsheikh, Elzafir;Younoszai, Zahra;Younossi, Zobair M.
背景资料：非酒精性脂肪性肝病（NAFLD）与冠状动脉疾病（CAD）和心脏相关死亡率相关。目的：评估内皮功能障碍标志物（Endocan、高迁移率族蛋白1 [HMGB 1]和抗内皮细胞抗体[AECAs]）与NAFLD中CAD风险之间的相关性。其中，77人患有NAFLD（85%有记录的CAD）。在排除其他肝脏疾病原因后，通过肝脏超声和/或脂肪肝指数诊断NAFLD。通过冠状动脉造影确定CAD的诊断和严重程度。采用酶联免疫吸附试验技术测定血清中内皮聚糖（ng/mL）和HMGB 1（ng/mL）浓度。结果：NAFLD合并CAD患者血清内皮素水平明显高于NAFLD不合并CAD患者（P = 0.006）。此外，委员会认为，内皮素水平（比值比[OR] 38.66 [95%置信区间{CI} 1.10-999.99]）和高脂血症（OR 5.62 [95%CI 1.36-23.19]）与冠心病的危险性和高血清高密度脂蛋白胆固醇水平显著相关（OR 0.92 [95% CI 0.87-0.97]）对CAD具有保护作用。NAFLD合并CAD组血清HMGB 1水平显著低于NAFLD不合并CAD组（P = 0.0003）。有趣的是，在我们的NAFLD队列中，血清内皮素水平与CAD的严重程度正相关（r = 0.27; P < 0.05），而HMGB 1水平与CAD的严重程度负相关（r = -0.35; P < 0.05）。结论：NAFLD患者血管内皮功能障碍的标志物可能与冠心病的发生有关。
Background: Non-alcoholic fatty liver disease (NAFLD) has been associated with coronary artery disease (CAD) and cardiac-related mortality.Aim: To assess the association between endothelial dysfunction markers (Endocan, high mobility group box 1 [HMGB1], and anti-endothelial cell antibodies [AECAs]) and the risk of CAD in NAFLD.Methods: Ninety-one patients scheduled for coronary angiography for chest pain were included. Of these, 77 had NAFLD (85% with documented CAD). NAFLD was diagnosed after exclusion of other causes of liver diseases and by hepatic ultrasound and/or fatty liver index. Diagnosis and severity of CAD were established with coronary angiography. Endocan (ng/mL) and HMGB1 (ng/mL) concentrations were determined in the serum using enzyme-linked immunosorbent assay technique. AECAs were quantified in sera using flow cytometry.Results: NAFLD patients with CAD had higher serum endocan level as compared with NAFLD without CAD (P = 0.006). Furthermore, levels of endocan (odds ratio [OR] 38.66 [95% confidence interval {CI} 1.10-999.99]) and hyperlipidemia (OR 5.62 [95% CI 1.36-23.19]) were significantly associated with the risk of CAD and high serum high-density lipoprotein cholesterol level (OR 0.92 [95% CI 0.87-0.97]) was protective against CAD. On the other hand, serum level of HMGB1 was significantly lower in NAFLD patients with CAD than NAFLD patients without CAD (P = 0.0003). Interestingly, in our NAFLD cohort, serum endocan levels positively correlated the severity of CAD (r = 0.27; P < 0.05), whereas HMGB1 levels negatively correlated with severity of CAD (r = -0.35; P < 0.05). The levels of AECA were not significantly associated with CAD in NAFLD.Conclusion: Markers of endothelial dysfunction in patients NAFLD patients may be associated with the risk for CAD.