Ultrasonographic profile of non-alcoholic fatty liver disease manifestation in patients with hypertension

Abstract

Objective — to determine the features of liver ultrasonographic parameters in patients with combination of non‑alcoholic fatty liver disease (NAFLD) and hypertension (HT).
 Materials and methods. The investigation involved 115 patients with NAFLD at the stage of non‑alcoholic steatohepatitis. The main group (n = 63) consisted of patients with comorbid NAFLD and HT, the comparison group (n = 52) included patients with isolated NAFLD, and the control group consisted of 20 apparently healthy individuals. Based on the results of clinical and laboratory tests, indices of the degree of liver fibrosis were calculated: Fibrosis‑4 (FIB‑4) and NAFLD fibrosis score (NFS). A comprehensive assessment of ultrasonographic signs of liver and surrounding organs damage and a semi‑quantitative assessment of liver steatosis according to the Ultrasound fatty liver indicator (US‑FLI) scale was performed during ultrasound examinations.
 Results. Among the main ultrasound signs of steatosis, a significant liver size increase, liver parenchyma hyperechogenicity, changes in the vascular pattern, a hepatic portal system overload were found in all patients with NAFLD and HT. The average US‑FLI test result in the group with comorbid NAFLD and HT was 6 points (95 % CI 5.24; 6.12). This value was significantly higher compared to the group with isolated NAFLD, where the results averaged 3 points (95 % CI 2.91; 3.74; p < 0.001). FIB‑4 and NFS indices were also significantly higher in patients with NAFLD and HT. An increased risk of liver fibrosis was found in patients with comorbidity of NAFLD and HT. The significant effects of concomitant HT on the progression of fibrotic changes in the liver parenchyma in NAFLD have been determined.
 Conclusions. Concomitant HT in patients with NAFLD introduces deviations in the ultrasonographic profile of the liver. It is manifested by a significantly more frequent detection of the main signs of steatosis, more expressive changes in quantitative ultrasound parameters and qualitative signs of liver steatosis according to the US‑FLI test. The non‑invasive fibrosis tests results indicate an intensification of fibrosis processes in the liver parenchyma in patients with NAFLD and HT. The obtained data allow us to consider HT as a trigger factor for the progression of liver fibrotic changes in patients with NAFLD.