VASCULAR FUNCTION CHANGES IN NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)/ NONALCOHOLIC STEATOHEPATITIS

Objective: The main cause of death among patients with NAFLD is cardiovascular disease. It is firmly established that NAFLD is major risk factors for cardiovascular diseases and Aortic stiffness is an independent predictor of cardiovascular events. Understanding this relationship aids in identifying potential risks and developing targeted interventions, ultimately improving preventive care strategies for individuals with NAFLD. Through the global approach, we investigate to examine the link between the severity of metabolic steatosis and the various indices of vascular function. Design and method: Patients followed consecutively at the University Hospital of Quebec were recruited to participate. We assessed aortic stiffness, brachial stiffness, Global stiffness, Intima-Media Thickness and the flow-dependent vasodilation (FMD). The participants were divided according to the stage of hepatic steatosis, either early or advanced. Results: In this study, we had 50 patients. Thirteen of them were in the early NASH group, with an average age of 65.1 ± 11.0, and 37 patients were in the advanced NASH group, with an average age of 54.0 ± 12.4. According to the classification into early and advanced NASH, there was a significant difference in brachial diastolic pressure between the two groups (69.2 ± 8.7 vs. 75.3 ± 8.0; P = 0.02). Regarding carotid artery remodeling parameters, static circumferential wall stress was higher in the advanced NASH group (69.2 ± 15.1 vs. 86.4 ± 20.5; P < 0.01), while the Wall-to-Lumen Ratio was lower among the advanced NASH patients (0.095 ± 0.02 vs. 0.078 ± 0.01; P < 0.01). Patients in the advanced stage had smaller intima-media thickness, and the artery diameter became wider (0.652 ± 0.169 vs. 0.555 ± 0.097; P < 0.05). Conclusions: In this preliminary analysis, there were no associations between the severity of NASH and markers of arteriosclerosis, atherosclerosis and endothelial dysfunction. However, advanced NASH was associated with a hypotrophic remodeling of the common carotid artery (large elastic vessel), even after adjustment for age, diastolic BP, and sex. In a similar manner, the diameter of the brachial artery (medium-sized muscular vessel) seemed to be higher with advanced NASH.