Nonalcoholic fatty liver disease is associated with low HDL cholesterol and coronary angioplasty in patients with type 2 diabetes.

BACKGROUND: There is evidence that nonalcoholic fatty liver disease (NAFLD) is associated with increased cardiovascular risk. In this study we examined factors associated with the presence of NAFLD and the prevalence of macroangiopathy in patients with type 2 diabetes. MATERIAL AND METHODS: Subjects were 101 consecutive patients with type 2 diabetes: 72 with NAFLD and 29 free of NAFLD. NAFLD was diagnosed by ultrasonography. Serum lipids were measured enzymatically and glycated hemoglobin HbA1c was measured by HPLC. RESULTS: The mean age of patients was 53.1 ± 10.4 in the NAFLD group and 44.9 ± 10.9 years in patients without NAFLD (p<0.001). The mean duration of diabetes was 10 ± 6.3 years in patients with NAFLD and 15.1 ± 7.8 years in those without NAFLD (p<0.001). Mean values of glycated hemoglobin A1c were similar in both groups. Patients with NAFLD were characterized by a significantly higher prevalence of coronary angioplasty (20.8% vs. 0%, p=0.008). Overweight and obesity were observed in a higher percentage of patients with NAFLD (p<0.001). Patients with NAFLD were characterized by significantly higher values of alanine transaminase (p=0.033), and lower serum concentrations of HDL-cholesterol (p<0.001) and creatinine (p=0.034). Logistic regression analysis (p<0.001) revealed that NAFLD was positively associated with waist circumference above normal (women >80 cm, men >94 cm) (p=0.0083) and alanine transaminase activity (p=0.0164), and negatively with creatinine concentration (p=0.0226). In a second logistic regression model (p<0.001), waist circumference (p<0.007) and total cholesterol (p<0.008) were positive predictors, while HDL-C (p<0.003) was a negative predictor of NAFLD. CONCLUSIONS: The results of the study suggest that NAFLD is associated with visceral obesity and low HDL-cholesterol in patients with type 2 diabetes.

Intima-media thickness correlates with features of metabolic syndrome in young people with a clinical diagnosis of familial hypercholesterolaemia.

BACKGROUND: Familial hypercholesterolaemia (FH) is a monogenic lipid metabolism disorder characterised by markedly elevated serum low-density lipoprotein (LDL) cholesterol level due to a mutation in the LDL receptor gene. Clinical features of FH include premature atherosclerosis and coronary artery disease. AIM: To explore associations between noninvasive markers of atherosclerosis including intima-media thickness (IMT) and pulse wave velocity (PWV) and blood lipids, blood pressure (BP) and obesity in a group of young patients with FH. METHODS: Study population included 36 patients aged < 35 years with the diagnosis of FH based on the Simon Broome Register criteria, and their 49 relatives who comprised the control group free of FH. RESULTS: Mean IMT values were higher in FH patients than controls (0.60 ± 0.19 vs. 0.53 ± 0.07 mm, respectively, p < 0.05).Mean body mass index (BMI) and waist circumference were similar in patients and controls. The prevalence of carotid atherosclerotic plaques was significantly higher among FH patients (n = 6) than in controls (n = 1) (21.4% vs. 2.6%, p = 0.012). Arterial hypertension was present in 27.8% of patients with FH and 16.3% of subjects in the control group. Systolic blood pressure (SBP) in FH patients correlated significantly with age (r = 0.35), BMI (r = 0.48) and waist circumference (r = 0.47), and diastolic blood pressure (DBP) correlated with BMI (r = 0.42) and waist circumference (r = 0.41). PWV correlated significantly with age (r = 0.44), SBP (r = 0.63) and DBP (r = 0.52). We did not find any correlations between IMT and serum lipids, BP or obesity indices in FH patients. CONCLUSIONS: Our findings show a higher rate of arterial hypertension in young FH patients compared to their relatives free of FH, with significant associations between BP and indices of obesity and arterial stiffness. Intensive lipid lowering and antihypertensive therapy along with a reduction in central fat may be considered a mandatory treatment strategy in young FH patients to prevent atherosclerosis and increased arterial stiffness.