Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease.

Mavidi Sunil Kumar,Akanksha Singh,Piyush Ranjan,K K Deepak,Naval K Vikram,R M Pandey,Sanjay Sharma,Ashok Kumar Jaryal,R Lakshmy

doi:10.1155/2016/5160754

Abstract

Aim. The present study was designed to evaluate the heart rate variability (HRV) in nonalcoholic fatty liver disease (NAFLD) and to assess the effect of grade of NAFLD and diabetic status on HRV. Methods. This cross-sectional study included 75 subjects (25 NAFLD without diabetes, 25 NAFLD with diabetes, and 25 controls). Measurements included anthropometry, body composition analysis, estimation of plasma glucose, serum lipids, hsCRP, and serum insulin. HRV analysis was performed in both time and frequency domains. Results. The time and frequency domain indices of overall variability (SDNN, total power) were significantly lower in NAFLD with diabetes as compared to the controls. However, the LF : HF ratio did not differ among the three groups. The variables related to obesity, lipid profile, and glucose metabolism were also higher in NAFLD with diabetes and those with Grade II NAFLD without diabetes, as compared to controls. Multivariate stepwise regression analysis showed a negative correlation between HRV and total cholesterol and fat percentage. Conclusion. The grade of NAFLD as well as diabetic status contributes to the decrease in the cardiovascular autonomic function, with diabetic status rather than grade of NAFLD playing a critical role. Serum lipids and adiposity may also contribute to cardiac autonomic dysfunction.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological condition characterised by lipid deposition in the liver and is a common cause of liver dysfunction
In the present study we evaluated the association of indices of Heart Rate Variability (HRV) with anthropometric variables, lipid profile, and diabetic status in patients with and without NAFLD
The data of 7 subjects in the NAFLD without diabetes group was excluded from HRV due to presence of artefacts that prevented computation

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological condition characterised by lipid deposition in the liver and is a common cause of liver dysfunction. Apart from an increased risk of liver-related morbidity and mortality, patients of NAFLD have higher cardiovascular risk [3, 4] especially when present along with type 2 diabetes (T2DM) [4, 5]. Imbalance in autonomic function has been proposed as a component in pathogenesis of NAFLD [7]. The autonomic dysfunction has been shown to be higher in the NAFLD. The autonomic symptom burden assessed by orthostatic grading scale was higher in nondiabetic NAFLD [8] and the sudomotor dysfunction was higher in the NAFLD after accounting for all confounders [9]

Methods

Results

Discussion

Conclusion