The degree of hepatic steatosis associates with impaired cardiac and autonomic function
[Display omitted] •Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat...
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| creator | Houghton, David Zalewski, Paweł Hallsworth, Kate Cassidy, Sophie Thoma, Christian Avery, Leah Slomko, Joanna Hardy, Timothy Burt, Alastair D. Tiniakos, Dina Hollingsworth, Kieren G. Taylor, Roy Day, Christopher P. Masson, Steven McPherson, Stuart Anstee, Quentin M. Newton, Julia L. Trenell, Michael I. |
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•Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat on diastolic autonomic dysfunction.
Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver-related morbidity and mortality. The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function, as well as to assess how impairment in cardiac and autonomic function is influenced by metabolic risk factors.
Cardiovascular and autonomic function were assessed in 96 sedentary individuals: i) non-alcoholic fatty liver disease (NAFLD) (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), ii) Hepatic steatosis and alcohol (dual aetiology fatty liver disease [DAFLD]) (n = 16, hepatic steatosis >5%, consuming >20 g/day of alcohol) and iii) CONTROL (n = 34, no cardiac, liver or metabolic disorders, |
| doi_str_mv | 10.1016/j.jhep.2019.01.035 |
| format | Article |
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•Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat on diastolic autonomic dysfunction.
Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver-related morbidity and mortality. The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function, as well as to assess how impairment in cardiac and autonomic function is influenced by metabolic risk factors.
Cardiovascular and autonomic function were assessed in 96 sedentary individuals: i) non-alcoholic fatty liver disease (NAFLD) (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), ii) Hepatic steatosis and alcohol (dual aetiology fatty liver disease [DAFLD]) (n = 16, hepatic steatosis >5%, consuming >20 g/day of alcohol) and iii) CONTROL (n = 34, no cardiac, liver or metabolic disorders, <20 g/day of alcohol).
Patients with NAFLD and DAFLD had significantly impaired cardiac and autonomic function when compared with controls. Diastolic variability and systolic variability (LF/HF-sBP [n/1]; 2.3 (1.7) and 2.3 (1.5) vs. 3.4 (1.5), p <0.01) were impaired in patients with NAFLD and DAFLD when compared to controls, with DAFLD individuals showing a decrease in diastolic variability relative to NAFLD patients. Hepatic steatosis and fasting glucose were negatively correlated with stroke volume index. Fibrosis stage was significantly negatively associated with mean blood pressure (r = −0.47, p = 0.02), diastolic variability (r = −0.58, p ≤0.01) and systolic variability (r = −0.42, p = 0.04). Hepatic steatosis was independently associated with cardiac function (p ≤0.01); TNF-α (p ≤0.05) and CK-18 (p ≤0.05) were independently associated with autonomic function.
Cardiac and autonomic impairments appear to be dependent on level of liver fat, metabolic dysfunction, inflammation and fibrosis staging, and to a lesser extent alcohol intake. Interventions should be sought to moderate the excess cardiovascular risk in patients with NAFLD or DAFLD.
Increased levels of fat in the liver impair the ability of the cardiovascular system to work properly. The amount of fat in the liver, metabolic control, inflammation and alcohol are all linked to the degree that the cardiovascular system is affected.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2019.01.035</identifier><identifier>PMID: 30769007</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Aged ; Alcohol ; Alcoholic beverages ; Autonomic ; Autonomic nervous system ; Autonomic Nervous System - physiopathology ; Blood pressure ; Cardiac ; Cardiovascular diseases ; Cardiovascular Diseases - etiology ; Fatty liver ; Fatty Liver - complications ; Fatty Liver - physiopathology ; Female ; Fibrosis ; Heart - physiopathology ; Hemodynamics - physiology ; Humans ; Inflammation ; Liver diseases ; Liver fat ; Magnetic resonance spectroscopy ; Male ; Metabolic disorders ; Metabolism ; Middle Aged ; Morbidity ; Non-alcoholic Fatty Liver Disease - physiopathology ; Risk factors ; Steatosis ; Tumor necrosis factor-α</subject><ispartof>Journal of hepatology, 2019-06, Vol.70 (6), p.1203-1213</ispartof><rights>2019 The Authors</rights><rights>Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Jun 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-f7e393c2eae386b3af408de72f88c3b8f63cf8b1f79edcf9e885ec4946ffdc683</citedby><cites>FETCH-LOGICAL-c428t-f7e393c2eae386b3af408de72f88c3b8f63cf8b1f79edcf9e885ec4946ffdc683</cites><orcidid>0000-0002-0293-3416</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2019.01.035$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30769007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Houghton, David</creatorcontrib><creatorcontrib>Zalewski, Paweł</creatorcontrib><creatorcontrib>Hallsworth, Kate</creatorcontrib><creatorcontrib>Cassidy, Sophie</creatorcontrib><creatorcontrib>Thoma, Christian</creatorcontrib><creatorcontrib>Avery, Leah</creatorcontrib><creatorcontrib>Slomko, Joanna</creatorcontrib><creatorcontrib>Hardy, Timothy</creatorcontrib><creatorcontrib>Burt, Alastair D.</creatorcontrib><creatorcontrib>Tiniakos, Dina</creatorcontrib><creatorcontrib>Hollingsworth, Kieren G.</creatorcontrib><creatorcontrib>Taylor, Roy</creatorcontrib><creatorcontrib>Day, Christopher P.</creatorcontrib><creatorcontrib>Masson, Steven</creatorcontrib><creatorcontrib>McPherson, Stuart</creatorcontrib><creatorcontrib>Anstee, Quentin M.</creatorcontrib><creatorcontrib>Newton, Julia L.</creatorcontrib><creatorcontrib>Trenell, Michael I.</creatorcontrib><title>The degree of hepatic steatosis associates with impaired cardiac and autonomic function</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>[Display omitted]
•Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat on diastolic autonomic dysfunction.
Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver-related morbidity and mortality. The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function, as well as to assess how impairment in cardiac and autonomic function is influenced by metabolic risk factors.
Cardiovascular and autonomic function were assessed in 96 sedentary individuals: i) non-alcoholic fatty liver disease (NAFLD) (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), ii) Hepatic steatosis and alcohol (dual aetiology fatty liver disease [DAFLD]) (n = 16, hepatic steatosis >5%, consuming >20 g/day of alcohol) and iii) CONTROL (n = 34, no cardiac, liver or metabolic disorders, <20 g/day of alcohol).
Patients with NAFLD and DAFLD had significantly impaired cardiac and autonomic function when compared with controls. Diastolic variability and systolic variability (LF/HF-sBP [n/1]; 2.3 (1.7) and 2.3 (1.5) vs. 3.4 (1.5), p <0.01) were impaired in patients with NAFLD and DAFLD when compared to controls, with DAFLD individuals showing a decrease in diastolic variability relative to NAFLD patients. Hepatic steatosis and fasting glucose were negatively correlated with stroke volume index. Fibrosis stage was significantly negatively associated with mean blood pressure (r = −0.47, p = 0.02), diastolic variability (r = −0.58, p ≤0.01) and systolic variability (r = −0.42, p = 0.04). Hepatic steatosis was independently associated with cardiac function (p ≤0.01); TNF-α (p ≤0.05) and CK-18 (p ≤0.05) were independently associated with autonomic function.
Cardiac and autonomic impairments appear to be dependent on level of liver fat, metabolic dysfunction, inflammation and fibrosis staging, and to a lesser extent alcohol intake. Interventions should be sought to moderate the excess cardiovascular risk in patients with NAFLD or DAFLD.
Increased levels of fat in the liver impair the ability of the cardiovascular system to work properly. The amount of fat in the liver, metabolic control, inflammation and alcohol are all linked to the degree that the cardiovascular system is affected.</description><subject>Adult</subject><subject>Aged</subject><subject>Alcohol</subject><subject>Alcoholic beverages</subject><subject>Autonomic</subject><subject>Autonomic nervous system</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Blood pressure</subject><subject>Cardiac</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Fatty liver</subject><subject>Fatty Liver - complications</subject><subject>Fatty Liver - physiopathology</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Heart - physiopathology</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Liver diseases</subject><subject>Liver fat</subject><subject>Magnetic resonance spectroscopy</subject><subject>Male</subject><subject>Metabolic disorders</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Non-alcoholic Fatty Liver Disease - physiopathology</subject><subject>Risk factors</subject><subject>Steatosis</subject><subject>Tumor necrosis factor-α</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM2KFDEURoMoTjv6Ai4k4MZNlTdJdZICN8Mw_sCAmxGXIZ3c2Cm6Km2ScvDtTdOji1m4upvzHS6HkNcMegZMvp_6aY_HngMbe2A9iO0TsmESoAM5sKdk0yDdaa70BXlRygQAAsbhObkQoOQIoDbk-90eqccfGZGmQJvP1uhoqWhrKrFQW0py0VYs9D7WPY3z0caMnjqbfbSO2sVTu9a0pLkNw7q4GtPykjwL9lDw1cO9JN8-3txdf-5uv376cn1127mB69oFhWIUjqNFoeVO2DCA9qh40NqJnQ5SuKB3LKgRvQsjar1FN4yDDME7qcUleXf2HnP6uWKpZo7F4eFgF0xrMZyNcsuU1Lyhbx-hU1rz0r4znG85V0Ip1Sh-plxOpWQM5pjjbPNvw8CcspvJnLKbU3YDzLTsbfTmQb3uZvT_Jn87N-DDGcDW4lfEbIqLuDj0raWrxqf4P_8fbIKUow</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Houghton, David</creator><creator>Zalewski, Paweł</creator><creator>Hallsworth, Kate</creator><creator>Cassidy, Sophie</creator><creator>Thoma, Christian</creator><creator>Avery, Leah</creator><creator>Slomko, Joanna</creator><creator>Hardy, Timothy</creator><creator>Burt, Alastair D.</creator><creator>Tiniakos, Dina</creator><creator>Hollingsworth, Kieren G.</creator><creator>Taylor, Roy</creator><creator>Day, Christopher P.</creator><creator>Masson, Steven</creator><creator>McPherson, Stuart</creator><creator>Anstee, Quentin M.</creator><creator>Newton, Julia L.</creator><creator>Trenell, Michael I.</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0293-3416</orcidid></search><sort><creationdate>201906</creationdate><title>The degree of hepatic steatosis associates with impaired cardiac and autonomic function</title><author>Houghton, David ; Zalewski, Paweł ; Hallsworth, Kate ; Cassidy, Sophie ; Thoma, Christian ; Avery, Leah ; Slomko, Joanna ; Hardy, Timothy ; Burt, Alastair D. ; Tiniakos, Dina ; Hollingsworth, Kieren G. ; Taylor, Roy ; Day, Christopher P. ; Masson, Steven ; McPherson, Stuart ; Anstee, Quentin M. ; Newton, Julia L. ; Trenell, Michael I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-f7e393c2eae386b3af408de72f88c3b8f63cf8b1f79edcf9e885ec4946ffdc683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alcohol</topic><topic>Alcoholic beverages</topic><topic>Autonomic</topic><topic>Autonomic nervous system</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Blood pressure</topic><topic>Cardiac</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Fatty liver</topic><topic>Fatty Liver - complications</topic><topic>Fatty Liver - physiopathology</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Heart - physiopathology</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Liver diseases</topic><topic>Liver fat</topic><topic>Magnetic resonance spectroscopy</topic><topic>Male</topic><topic>Metabolic disorders</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Non-alcoholic Fatty Liver Disease - physiopathology</topic><topic>Risk factors</topic><topic>Steatosis</topic><topic>Tumor necrosis factor-α</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Houghton, David</creatorcontrib><creatorcontrib>Zalewski, Paweł</creatorcontrib><creatorcontrib>Hallsworth, Kate</creatorcontrib><creatorcontrib>Cassidy, Sophie</creatorcontrib><creatorcontrib>Thoma, Christian</creatorcontrib><creatorcontrib>Avery, Leah</creatorcontrib><creatorcontrib>Slomko, Joanna</creatorcontrib><creatorcontrib>Hardy, Timothy</creatorcontrib><creatorcontrib>Burt, Alastair D.</creatorcontrib><creatorcontrib>Tiniakos, Dina</creatorcontrib><creatorcontrib>Hollingsworth, Kieren G.</creatorcontrib><creatorcontrib>Taylor, Roy</creatorcontrib><creatorcontrib>Day, Christopher P.</creatorcontrib><creatorcontrib>Masson, Steven</creatorcontrib><creatorcontrib>McPherson, Stuart</creatorcontrib><creatorcontrib>Anstee, Quentin M.</creatorcontrib><creatorcontrib>Newton, Julia L.</creatorcontrib><creatorcontrib>Trenell, Michael I.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Houghton, David</au><au>Zalewski, Paweł</au><au>Hallsworth, Kate</au><au>Cassidy, Sophie</au><au>Thoma, Christian</au><au>Avery, Leah</au><au>Slomko, Joanna</au><au>Hardy, Timothy</au><au>Burt, Alastair D.</au><au>Tiniakos, Dina</au><au>Hollingsworth, Kieren G.</au><au>Taylor, Roy</au><au>Day, Christopher P.</au><au>Masson, Steven</au><au>McPherson, Stuart</au><au>Anstee, Quentin M.</au><au>Newton, Julia L.</au><au>Trenell, Michael I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The degree of hepatic steatosis associates with impaired cardiac and autonomic function</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2019-06</date><risdate>2019</risdate><volume>70</volume><issue>6</issue><spage>1203</spage><epage>1213</epage><pages>1203-1213</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>[Display omitted]
•Patients with elevated liver fat and poor metabolic control have impaired cardiac and autonomic function.•Liver fat, metabolic dysfunction, inflammation and fibrosis staging correlate with cardiac and autonomic dysfunction.•Elevated alcohol intake enhanced the impact of liver fat on diastolic autonomic dysfunction.
Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver-related morbidity and mortality. The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function, as well as to assess how impairment in cardiac and autonomic function is influenced by metabolic risk factors.
Cardiovascular and autonomic function were assessed in 96 sedentary individuals: i) non-alcoholic fatty liver disease (NAFLD) (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), ii) Hepatic steatosis and alcohol (dual aetiology fatty liver disease [DAFLD]) (n = 16, hepatic steatosis >5%, consuming >20 g/day of alcohol) and iii) CONTROL (n = 34, no cardiac, liver or metabolic disorders, <20 g/day of alcohol).
Patients with NAFLD and DAFLD had significantly impaired cardiac and autonomic function when compared with controls. Diastolic variability and systolic variability (LF/HF-sBP [n/1]; 2.3 (1.7) and 2.3 (1.5) vs. 3.4 (1.5), p <0.01) were impaired in patients with NAFLD and DAFLD when compared to controls, with DAFLD individuals showing a decrease in diastolic variability relative to NAFLD patients. Hepatic steatosis and fasting glucose were negatively correlated with stroke volume index. Fibrosis stage was significantly negatively associated with mean blood pressure (r = −0.47, p = 0.02), diastolic variability (r = −0.58, p ≤0.01) and systolic variability (r = −0.42, p = 0.04). Hepatic steatosis was independently associated with cardiac function (p ≤0.01); TNF-α (p ≤0.05) and CK-18 (p ≤0.05) were independently associated with autonomic function.
Cardiac and autonomic impairments appear to be dependent on level of liver fat, metabolic dysfunction, inflammation and fibrosis staging, and to a lesser extent alcohol intake. Interventions should be sought to moderate the excess cardiovascular risk in patients with NAFLD or DAFLD.
Increased levels of fat in the liver impair the ability of the cardiovascular system to work properly. The amount of fat in the liver, metabolic control, inflammation and alcohol are all linked to the degree that the cardiovascular system is affected.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>30769007</pmid><doi>10.1016/j.jhep.2019.01.035</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0293-3416</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of hepatology, 2019-06, Vol.70 (6), p.1203-1213 |
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| language | eng |
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| subjects | Adult Aged Alcohol Alcoholic beverages Autonomic Autonomic nervous system Autonomic Nervous System - physiopathology Blood pressure Cardiac Cardiovascular diseases Cardiovascular Diseases - etiology Fatty liver Fatty Liver - complications Fatty Liver - physiopathology Female Fibrosis Heart - physiopathology Hemodynamics - physiology Humans Inflammation Liver diseases Liver fat Magnetic resonance spectroscopy Male Metabolic disorders Metabolism Middle Aged Morbidity Non-alcoholic Fatty Liver Disease - physiopathology Risk factors Steatosis Tumor necrosis factor-α |
| title | The degree of hepatic steatosis associates with impaired cardiac and autonomic function |
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