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Non-Alcoholic Fatty Liver Disease (NAFLD) - Is it an Emerging Risk Factor for Coronary Artery Disease?: Preliminary
Manopriya Thiruvagounder1, Shaheen Khan, Dhastagir S Sheriff
1Department of Life Sciences, University of Calicut, Calicut, Kerala, India.
Insights
Non-alcoholic fatty liver disease (NAFLD) is linked to higher inflammation markers in coronary artery disease (CAD) patients. This suggests NAFLD may worsen cardiovascular disease risk.
Area of Science:
- Cardiology
- Hepatology
- Internal Medicine
Background:
- Coronary artery disease (CAD) is a significant global health concern.
- Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as a systemic disease.
- The relationship between NAFLD and CAD requires further investigation.
Purpose of the Study:
- To determine the prevalence of NAFLD in patients diagnosed with CAD.
- To investigate potential links between NAFLD and inflammatory markers in CAD patients.
Main Methods:
- A cohort of 149 CAD patients and 100 healthy controls were analyzed.
- Blood samples were assessed for liver function tests, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and plasminogen activator inhibitor I (PAI-I).
- NAFLD diagnosis in CAD patients was confirmed using ultrasonography and serum alanine aminotransferase (ALT) levels.
Main Results:
- CAD patients with NAFLD exhibited elevated liver enzymes and marginally higher A1C levels compared to controls.
- Significantly higher levels of TNF-α and PAI-I were observed in CAD patients with NAFLD.
- Increased CRP and uric acid, alongside reduced adiponectin, were noted in CAD patients, indicating a proinflammatory state.
Conclusions:
- Elevated PAI-I and TNF-α levels in CAD patients suggest a proinflammatory status potentially driven by NAFLD.
- NAFLD may contribute to the progression of cardiovascular disease (CVD) by exacerbating inflammation.
- Early identification and management of NAFLD in CAD patients could mitigate cardiovascular event risk.
Objectives:
The objective of this study was to identify the presence of non-alcoholic fatty liver disease (NAFLD) in patients with coronary artery disease (CAD).
Methods:
149 patients were selected, who had been referred to the Institute of Cardiology, Banglore, India, between January 2007 and June 2009 and diagnosed with CAD. Four patients did not participate in the study. Venous blood samples were taken from these cases, and agematched healthy controls who came for a master health check-up (N = 100). All were subjected to routine liver function tests including serum transaminases, enzyme immunoassays for plasminogen activator inhibitor I (PAI-I), C reactive protein (CRP), and tumour necrosis factor-alpha (TNF-α). Using ultrasonography and serum alanine aminotransferase (ALT) levels, the presence of NAFLD in CAD patients was reported.
Results:
CAD patients with NAFLD had significantly higher liver enzymes and marginally higher A1C levels compared to control subjects. Levels of TNF-α and PAI-I were higher in CAD patients with NAFLD compared to both female and male controls (P <0.1 and P <0.05). Levels of CRP (P <0.01 in both groups) and uric acid were increased in both group of patients (P <0.05 and P <0.01 in male and female patients, respectively). Levels of adiponectin were significantly reduced in the patients compared to the controls (P <0.05 and P <0.001) in male and female patients respectively.
Conclusion:
The increased serum levels of PAI-I and TNF-α reflected the proinflammatory status in these CAD patients which may be due to the presence of NAFLD. This could contribute additively to the development of cardiovascular events (CVD).
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