Effects of metabolic syndrome with non-alcoholic fatty liver disease on subclinical atherosclerosis in elderly patients

Abstract

Objective To explore the relationship between metabolic syndrome(MS)with non-alcoholic fatty liver disease(NAFLD)and markers of subclinical atherosclerosis in elderly patients, including carotid intima-media thickness(CIMT), brachial-ankle pulse wave velocity(baPWV)and ankle-brachial pressure index(ABI). Methods A total of 235 elderly participants without coronary artery disease were enrolled in this cross-sectional study.The indexes such as age, gender, height, weight, body mass index(BMI), waist circumference and blood pressure were collected through standardized questionnaire and physical examination.The biochemical indicators including serum fasting blood glucose(FBG), blood lipids, homocysteine(Hcy), cystatin C and uric acid were measured by biochemical analyzer.CIMT and NAFLD were detected by ultrasound and baPWV, and ABI was determined by automatic arteriosclerosis measurement system.The association between MS, NAFLD and markers of subclinical atherosclerosis was assessed using multiple logistic regression analysis after adjusting for multiple cardiometabolic risk variables. Results There were no significant differences in baseline clinical data including age, gender, lifestyle information(smoking and alcohol consumption), physical activity etc.between groups.The differences in CIMT and baPWV were statistically significant between MS group and control group [(1.10±0.02)mm vs.(0.99±0.01)mm, (1 630±34)cm/s vs.(1 480±23)cm/s, both P<0.01]. The differences in CIMT, baPWV and ABI were statistically significant between NAFLD group and control group [(1.10±0.02)mm vs.(1.00±0.01)mm, (1 665±40)cm/s vs.(1 475±20)cm/s, 1.07±0.02 vs. 1.13±0.01, both P<0.01]. CIMT and baPWV were found to be significantly correlated with multiple cardiometabolic risk variables, whereas ABI was only associated with blood lipids parameters.Multivariate logistic regression analysis suggested that after adjusting for potential confounding factors, MS or NAFLD was not associated with subclinical atherosclerosis as defined by baPWV.However, individuals with both MS and NAFLD had a significantly higher risk of subclinical atherosclerosis as defined by CIMT(OR: 3.72, 95%CI: 1.42-9.70)or baPWV(OR: 3.43, 95%CI: 1.31-9.01)compared to normal subjects, even after adjusting for potential confounders. Conclusions The results show that MS and NAFLD have a synergistic impact on the subclinical atherosclerosis.Cardiovascular disease prevention should be strengthened in elderly patients with MS combined with NAFLD. Key words: Metabolic syndrome; Non-alcoholic fatty liver disease; Arteriosclerosis; Risk factors