1311 NONALCOHOLIC FATTY LIVER DISEASE IS NOT MORE FREQUENT AMONG HYPERTENSIVES AND NON-DIPPERS

Abstract

Arterial hypertension (AH) and nonalcoholic fatty liver disease (NAFLD) are both components of the metabolic syndrome although their concurrence is uncertain. Normal variation of blood pressure (BP) is characterized by a nighttime dip of 10–20%. The association of non-dipping status and NAFLD is also controversial. The aims of our study were to investigate the possible association of NAFLD and insulin resistance to AH and the effect of the dipping profile. Patients and Methods: 186 consecutive patients, referred to the Hypertensive Unit were included. Exclusion criteria: alcohol >40gr/d and >20gr/d for men and women, respectively, diabetes mellitus, viral or autoimmune hepatitis, cholestatic and druginduced liver disease. AH was defined as mean 24-hour ambulatory BP values >130/80mmHg. Dippers and non-dippers were defined according to whether nighttime BP drop was ≥ or < 10%, respectively. Body mass index (BMI), waist/hip ratio and blood results were evaluated. 24-hour BP monitoring, cardiac and abdominal ultrasounds were also performed. Results: 173 patients were eligible for analysis (82 with AH), mean age: 54.3±10.1 years (mean±SD). Patients with and without steatosis on ultrasound differed with respect to BMI (30.0±5.2 vs 25.6±3.8 kg/m, p < 0.0001), waist/hip ratio (103.1±13.2 vs 87.1±11.7 cm, p =0.002), triglycerides (135.9±62.4 vs 98.7±58.2mg%, p = 0.028), HOMA-IR (3.5±3.0 vs 1.5±0.8, p = 0.0004) and gGT (25.8±18.4 vs 16.0±7.7 IU/L, p = 0.025) whereas the frequency of hypertension was not different (52 vs 37%, p = 0.061). Characteristics of NAFLD were not different among hyperand normotensives. Among hypertensives, no differences were identified in the distribution of study parameters between dippers (N=48) and non-dippers (N=34). A more detailed analysis, after exclusion of reverse and extreme dippers, did not alter the results. Conclusions: 1. There is a trend for patients with steatosis to have AH (p =0.061) 2. All parameters related to NAFLD did not differ among patients with and without AH 3. Dipping status in patients with AH does not seem to be associated to NAFLD.