The relationship between endothelial dysfunction and serum aminotransferase levels in nonalcoholic fatty liver disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(6): 354-359

The relationship between endothelial dysfunction and serum aminotransferase levels in nonalcoholic fatty liver disease

Aydın Yıldırım1, Özer Soylu1, Alper Aydın1, Hakan Güveli2, Mehmet Ergelen1, Seden Çelık1, Baris Güngör1, Ender Özgün Çakmak1, Fatih Uzun1, Tuna Tezel1
1Siyami Ersek Thoracic And Cardiovascular Surgery Center, Cardiology Department, Istanbul, Turkey
2Haydarpasa Numune Hospital; Internal Medicine Gastroenterology Department, Istanbul, Turkey


OBJECTIVES
We assessed endothelial dysfunction, a precursor finding of atherosclerosis, and its severity in relation with aminotransferase levels in patients with nonalcoholic fatty liver disease (NAFLD).

STUDY DESIGN
Fifty-two patients without chronic alcohol ingestion were found to have NAFLD on routine abdominal ultrasonographic examination. Aminotransferase enzyme levels were normal in 26 patients (mean age 47±10 years), and elevated in 26 patients (mean age 48±12 years). The brachial artery was examined with Doppler ultrasonography to determine endothelium-dependent flow-mediated dilation in response to reactive hyperemia. Nonendothelium-dependent vasodilation was assessed following sublingual nitroglycerine administration. The results were compared with those of a control group of 27 age- and sex-matched patients (mean age 52±11 years) without NAFLD.

RESULTS
Patients with NAFLD had significantly higher fasting plasma glucose, HDL-cholesterol and total cholesterol levels, but the two patient groups did not differ in this respect. Baseline brachial diameters were similar in all the groups. Flow-mediated dilatation in response to reactive hyperemia significantly decreased in both patient groups compared to controls, but this decrease was more prominent in patients with an elevated aminotransferase level (p=0.03). No significant differences were found between the three groups following nitroglycerine administration (p>0.05). Multivariate analysis showed NAFLD as an independent determinant of reduced endothelium-dependent vascular relaxation (beta= -0.574, p=0.000).

CONCLUSION
Our data suggest that elevated aminotransferase enzyme levels in patients with NAFLD may predict endothelial dysfunction and the risk for cardiovascular events.

Keywords: Brachial artery/ultrasonography, coronary arteriosclerosis/physiopathology, endothelium, vascular/ultrasonography; fatty liver/complications; risk factors

How to cite this article
Aydın Yıldırım, Özer Soylu, Alper Aydın, Hakan Güveli, Mehmet Ergelen, Seden Çelık, Baris Güngör, Ender Özgün Çakmak, Fatih Uzun, Tuna Tezel. The relationship between endothelial dysfunction and serum aminotransferase levels in nonalcoholic fatty liver disease. Turk Kardiyol Dern Ars. 2007; 35(6): 354-359

Corresponding Author: Aydın Yıldırım, Türkiye
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