Skip to main content
SpringerLink
Log in

The Relationship Between Arterial Stiffness and Nonalcoholic Fatty Liver Disease

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Aim

Nonalcoholic fatty liver disease (NAFLD) is currently the most common form of chronic liver disease and some studies have documented its link with cardiovascular risk factors. This study aimed to investigate the association between arterial stiffness and NAFLD.

Methods

Among 1,442 health check-up subjects (955 men, 487 women), we examined the association between brachial-ankle pulse wave velocity (baPWV) as a measurement of arterial stiffness and the presence of NAFLD based on abdominal sonographic findings. Multivariate linear and logistic regression analyses were conducted to examine the independent association between baPWV and the presence of NAFLD in gender-specific manners.

Results

In multivariate regression analysis, NAFLD was found to be independently associated with baPWV in both men and women. Moreover, in multivariate logistic regression analysis, a graded independent relation was found between higher levels of baPWV and the prevalence risk of NAFLD. Odds ratios (95% CI) for the highest vs. the lowest quartile of baPWV were 1.85 (range, 1.13–2.62) in men and 3.32 (1.45–7.62) in women after adjusting for age, smoking status, regular exercise, body mass index, blood pressure, fasting plasma glucose, triglyceride, HDL-cholesterol, hypertension and diabetes.

Conclusion

Arterial stiffness was independently associated with the prevalence risk for NAFLD regardless of classical CVD risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

NAFLD:

Nonalcoholic fatty liver disease

CVD:

Cardiovascular disease

BaPWV:

Brachial-ankle pulse wave velocity

WBC:

White blood cell

CVs:

Coefficients of variations

HOMA-IR:

Homeostasis model assessment of the insulin resistance index

IMT:

Intima-media thickness

ROS:

Reactive oxygen species

IL-6:

Interleukin-6

TNF-α:

Tumor necrosis factor-α

NO:

Nitric oxide

PAI-1:

Plasminogen activator inhibitor-1

References

  1. Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–889.

    Article  PubMed  CAS  Google Scholar 

  2. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116:1413–1419.

    Article  PubMed  CAS  Google Scholar 

  3. Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001;50:1844–1850.

    Article  PubMed  CAS  Google Scholar 

  4. Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363:1341–1350.

    Article  PubMed  CAS  Google Scholar 

  5. Ekstedt M, Franzén LE, Mathiesen UL, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006;44:865–873.

    Article  PubMed  CAS  Google Scholar 

  6. Oliver JJ, Webb DJ. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vascular Biol. 2003;23:554–566.

    Article  CAS  Google Scholar 

  7. van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam study. Stroke. 2001;32:454–460.

    Article  PubMed  Google Scholar 

  8. Yamashina A, Tomiyama H, Arai T, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res. 2003;26:615–622.

    Article  PubMed  Google Scholar 

  9. Boutouyrie P, Tropeano AI, Asmar R, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002;39:10–15.

    Article  PubMed  CAS  Google Scholar 

  10. Kim YJ, Kim YJ, Cho BM, Lee S. Metabolic syndrome and arterial pulse wave velocity. Acta Cardiol. 2010;65:315–321.

    Article  PubMed  Google Scholar 

  11. Tanaka H, Munakata M, Kawano Y, et al. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. J Hypertens. 2009;27:2022–2027.

    Article  PubMed  CAS  Google Scholar 

  12. Seo SK, Cho S, Kim HY, et al. Bone mineral density, arterial stiffness, and coronary atherosclerosis in healthy postmenopausal women. Menopause. 2009;16:937–943.

    Article  PubMed  Google Scholar 

  13. Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J. 1986;292:13–15.

    Article  CAS  Google Scholar 

  14. Saadeh S, Younossi ZM, Remer EM, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002;123:745–750.

    Article  PubMed  Google Scholar 

  15. Villanova N, Moscatiello S, Ramilli S, et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology. 2005;42:473–480.

    Article  PubMed  Google Scholar 

  16. Salvi P, Ruffini R, Agnoletti D, et al. Increased arterial stiffness in nonalcoholic fatty liver disease: the Cardio-GOOSE study. J Hypertens. 2010;28:1699–1707.

    Article  PubMed  CAS  Google Scholar 

  17. Vlachopoulos C, Manesis E, Baou K, et al. Increased arterial stiffness and impaired endothelial function in nonalcoholic fatty liver disease: a pilot study. Am J Hypertens. 2010;23:1183–1189.

    Article  PubMed  Google Scholar 

  18. Park SH, Kim BI, Yun JW, et al. Insulin resistance and C-reactive protein as independent risk factors for non-alcoholic fatty liver disease in non-obese Asian men. J Gastroenterol Hepatol. 2004;19:694–698.

    Article  PubMed  CAS  Google Scholar 

  19. Wang CC, Lin SK, Tseng YF, et al. Elevation of serum aminotransferase activity increases risk of carotid atherosclerosis in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2009;24:1411–1416.

    Article  PubMed  Google Scholar 

  20. Kogiso T, Moriyoshi Y, Shimizu S, Nagahara H, Shiratori K. High-sensitivity C-reactive protein as a serum predictor of nonalcoholic fatty liver disease based on the Akaike information criterion scoring system in the general Japanese population. J Gastroenterol. 2009;44:313–321.

    Article  PubMed  CAS  Google Scholar 

  21. Wieckowska A, Papouchado BG, Li Z, et al. Increased hepatic and circulating interleukin-6 levels in human nonalcoholic steatohepatitis. Am J Gastroenterol. 2008;103:1372–1379.

    Article  PubMed  CAS  Google Scholar 

  22. Bahcecioglu IH, Yalniz M, Ataseven H, et al. Levels of serum hyaluronic acid, TNF-alpha and IL-8 in patients in nonalcoholic steatohepatitis. Heaptogastroenterology. 2005;52:1549–1553.

    CAS  Google Scholar 

  23. Lee YJ, Lee HR, Shim JY, Moon BS, Lee JH, Kim JK. Relationship between white blood cell count and nonalcoholic fatty liver disease. Dig Liver Dis. 2010;42:888–894.

    Article  PubMed  Google Scholar 

  24. Bhagat K, Vallance P. Effect of cytokines on nitric oxide pathways in human vasculature. Curr Opin Nephrol Hypertens. 1999;8:89–96.

    Article  PubMed  CAS  Google Scholar 

  25. Kahaleh MB, Fan PS. Effect of cytokines on the production of endothelin by endothelial cells. Clin Exp Rheumatol. 1997;15:163–167.

    PubMed  CAS  Google Scholar 

  26. Bataller R, Sancho-Bru P, Ginès P, et al. Activated human hepatic stellate cells express the renin-angiotensin system and synthesize angiotensin II. Gastroenterology. 2003;125:117–125.

    Article  PubMed  CAS  Google Scholar 

  27. Sookoian S, Castaño GO, Burgueño AL, et al. Circulating levels and hepatic expression of molecular mediators of atherosclerosis in nonalcoholic fatty liver disease. Atherosclerosis. 2009;209:585–591.

    Article  PubMed  Google Scholar 

  28. Targher G, Bertolini L, Rodella S, et al. Nonalcoholic fatty liver disease is independently associated with an increased incidence of cardiovascular events in type 2 diabetic patients. Diabetes Care. 2007;30:2119–2121.

    Article  PubMed  CAS  Google Scholar 

  29. Dunn W, Xu R, Wingard DL, et al. Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study. Am J Gastroenterol. 2008;103:2263–2271.

    Article  PubMed  Google Scholar 

  30. Adams LA, Lymp JF, St Sauver J, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129:113–121.

    Article  PubMed  Google Scholar 

  31. Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005;42:44–52.

    Article  PubMed  Google Scholar 

  32. Zelber-Sagi S, Nitzan-Kaluski D, Halpern Z, Oren R. Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures. Liver Int. 2006;26:856–863.

    Article  PubMed  Google Scholar 

  33. Jimba S, Nakagami T, Takahashi M, et al. Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults. Diabet Med. 2005;22:1141–1145.

    Article  PubMed  CAS  Google Scholar 

  34. Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J. 1986;292:13–15.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Mr. Tim Gitzen for his help in editing the manuscript.

Conflict of interest

No competing financial interests exist.

Author information

Authors and Affiliations

  1. Department of Family Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea

    Yong-Jae Lee, Jae-Yong Shim, Dong-Hyuk Jung & Hye-Ree Lee

  2. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Byung-Soo Moon

  3. Department of Pediatrics, CHA University College of Medicine, Seoul, Korea

    Youn-Ho Shin

  4. Department of Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Jung-Hyun Lee

Authors
  1. Yong-Jae Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae-Yong Shim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Byung-Soo Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Youn-Ho Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dong-Hyuk Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jung-Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hye-Ree Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hye-Ree Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, YJ., Shim, JY., Moon, BS. et al. The Relationship Between Arterial Stiffness and Nonalcoholic Fatty Liver Disease. Dig Dis Sci 57, 196–203 (2012). https://doi.org/10.1007/s10620-011-1819-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-011-1819-3

Keywords

Search

Navigation