Endothelial Dysfunction, a Marker of Atherosclerosis, Is Independent of Metabolic Syndrome in NAFLD Patients

Background. The study was designed to assess cardiovascular risk factors flow-mediated dilatation % (FMD%) and carotid intima-media thickness (CIMT) in NAFLD.Methods. 126 NAFLD subjects and 31 chronic hepatitis B (CHB) controls were studied. Measuring carotid intima-media thickness (CIMT) and the flow-mediated dilatation % (FMD%) by brachial artery Doppler ultrasound were used to assess atherosclerosis. The risk of cardiac events at 10 years (ROCE 10) was estimated by the Prospective Cardiovascular Munster Study (PROCAM) score.Results. 58 of 126 NAFLD have coexistent metabolic syndrome. Mean CIMT was0.73 +/- 0.041 mmamong NAFLD with MS,0.66 +/- 0.016 mmamong NAFLD without MS, and0.66 +/- 0.037in controls CHB patients. FMD% in NAFLD with MS was10.43 +/- 3.134%, but was8.56 +/- 3.581%in NAFLD without MS and17.78 +/- 6.051%in controls. PROCAM score of NAFLD with MS was46.95 +/- 6.509while in NAFLD without MS was38.2 +/- 3.738. Controls had a PROCAM score of38.13 +/- 5.755. ROCE 10 in NAFLD with MS was13.64 +/- 8.568while NAFLD without MS was5.55 +/- 1.949. Controls have a ROCE 10 of5.95 +/- 3.973. Post hoc analysis showed CIMT was dependent upon MS while FMD% was different between all subgroups hence independent of metabolic syndrome.Conclusion. The markers of endothelial dysfunction are significantly higher in patients with NAFLD than controls.