Abstract
BackgroundNon-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular atherosclerosis independent of classical risk factors. This study investigated the influence of NAFLD on autonomic changes, which is currently unknown.MethodsSubjects without an overt history of cardiovascular disease were enrolled during health checkups. The subjects diagnosed for NAFLD using ultrasonography underwent 5-min heart rate variability (HRV) measurements that was analyzed using the following indices: (1) the time domain with the standard deviation of N-N (SDNN) intervals and root mean square of successive differences between adjacent N-N intervals (rMSSD); (2) the frequency domain with low frequency (LF) and high frequency (HF) components; and (3) symbolic dynamics analysis. Routine blood biochemistry data and serum leptin levels were analyzed. Homeostasis model assessment of insulin resistance (HOMA-IR) was measured.ResultsOf the 497 subjects (mean age, 46.2 years), 176 (35.4%) had NAFLD. The HRV indices (Ln SDNN, Ln rMSSD, Ln LF, and Ln HF) were significantly decreased in the NAFLD group (3.51 vs 3.62 ms, 3.06 vs 3.22 ms, 5.26 vs 5.49 ms2, 4.49 vs 5.21 ms2, respectively, all P<0.05). Ln SDNN was significantly lower in the NAFLD group after adjustment for age, sex, hypertension, dyslipidemia, metabolic syndrome, body mass index, smoking, estimated glomerular filtration rate, HOMA-IR, and leptin (P<0.05). In the symbolic dynamic analysis, 0 V percentage was significantly higher in the NAFLD group (33.8% vs 28.7%, P = 0.001) and significantly correlated with linear HRV indices (Ln SDNN, Ln rMSSD, and Ln HF).ConclusionsNAFLD is associated with decreased Ln SDNN and increased 0 V percentage. The former association was independent of conventional cardiovascular risk factors and serum biomarkers (insulin resistance and leptin). Further risk stratification of autonomic dysfunction with falls or cardiovascular diseases by these HRV parameters is required in patients with NAFLD.
Highlights
[5] The association of Non-alcoholic fatty liver disease (NAFLD) with both carotid and coronary atherosclerosis has been reported to be independent of the classical risk factors for cardiovascular disease (CVD). [6,7] the effect of NAFLD on autonomic changes measured by heart rate variability (HRV) has not been reported
Time Domain and Frequency Domain of HRV The HRV indices of time and frequency domain (Ln standard deviation of N-N (SDNN), Ln rMSSD, Ln high frequency (HF), and Ln HF) were significantly decreased in the NAFLD group. These HRV indices were significantly correlated with clinical parameters, insulin resistance, and leptin
In general linear regression analysis after adjustment for age, sex, hypertension, dyslipidemia, liver function, metabolic syndrome, body mass index, smoking, estimated glomerular filtration rate (eGFR), Homeostasis model assessment of insulin resistance (HOMA-IR), and leptin, NAFLD was only negatively associated with Ln SDNN (P,0.05) rather than with Ln rMSSD, Ln HF, and Ln low frequency (LF)
Summary
Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of liver disorders, ranging from simple steatosis to non-alcoholic steatohepatitis, advanced fibrosis, and cirrhosis. [1] The clinical implications of NAFLD stem from its high prevalence, ranging from 10% to 30%, and the potential to progress to liver cirrhosis, hepatic failure, and hepatocellular carcinoma. [2] In Taiwan, the prevalence of NAFLD is 11.5–41% in the adult population, [3] and NAFLD is emerging as an important public health issue worldwide.The pathogenesis of NAFLD mainly involves insulin resistance and hyperleptinemia, which are related to atherosclerosis and autonomic changes. [4] Unsurprisingly, cardiovascular disease (CVD) is one of the major causes of death in patients with NAFLD. [5] The association of NAFLD with both carotid and coronary atherosclerosis has been reported to be independent of the classical risk factors for CVD. [6,7] the effect of NAFLD on autonomic changes measured by heart rate variability (HRV) has not been reported. The pathogenesis of NAFLD mainly involves insulin resistance and hyperleptinemia, which are related to atherosclerosis and autonomic changes. [5] The association of NAFLD with both carotid and coronary atherosclerosis has been reported to be independent of the classical risk factors for CVD. [6,7] the effect of NAFLD on autonomic changes measured by heart rate variability (HRV) has not been reported. [8] We hypothesized that NAFLD was associated with HRV changes independent of conventional cardiovascular risk factors and serum biomarkers (insulin resistance and leptin). Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular atherosclerosis independent of classical risk factors. This study investigated the influence of NAFLD on autonomic changes, which is currently unknown
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call