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Increased arterial stiffness in nonalcoholic fatty liver disease: the Cardio-GOOSE study

Paolo Salvi, Raffaele Ruffini, Davide Agnoletti, Elena Magnani, Gabriele Pagliarani, Giulia Comandini, Antonino Praticò, Claudio Borghi, Athanase Benetos, Paolo Pazzi
Journal of Hypertension 2010, 28 (8): 1699-707
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OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is a very frequent disease in Western countries. NAFLD shares with metabolic syndrome the same etiologic factors, such as obesity, diabetes, and dyslipidemia, which are also major cardiovascular risk factors. Cardio-GOOSE (Cardio-Gambettola ObservatOry liver Steatosis Estimation) is a population-based cohort study finalized to evaluate the relationship between NAFLD, subclinical vascular damage, and arterial stiffness.

METHODS: The study population consisted of 220 participants (123 women), aged between 30 and 70 years, who participated in the GOOSE study. Arterial stiffness was determined by measuring the carotid-femoral pulse wave velocity (PWV) by means of the PulsePen device. Preclinical atherosclerosis was detected by carotid intima-media thickness (IMT) measurement.

RESULTS: NAFLD was associated with metabolic syndrome in 48% of cases. IMT values were strongly related to metabolic syndrome factors. No significant differences in IMT were found between controls and patients with isolated NAFLD (0.77 +/- 0.15 mm versus 0.76 +/- 0.14 mm). Conversely, in patients with NAFLD associated with metabolic syndrome, IMT values were significantly higher than in patients with NAFLD alone (0.85 +/- 0.16 mm, P < 0.005). PWV values were significantly lower in controls compared to patients with isolated NAFLD (7.40 +/- 1.47 versus 7.98 +/- 1.51 m/s, P < 0.05) as well as patients with both NAFLD and metabolic syndrome (8.29 +/- 2.2 m/s, P < 0.001). The prevalence in NAFLD was increased in patients with the highest PWV values, and persisted after adjustment for factors determining metabolic syndrome (P < 0.05).

CONCLUSIONS: This study has shown a possible independent role of NAFLD in determining arterial stiffness.

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