Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Kumar, Mavidi Sunil; Singh, Akanksha; Jaryal, Ashok Kumar; Ranjan, Piyush; Deepak, Kishore Kumar; Sharma, Sanjay; Ramakrishnan, Lakshmy; Pandey, Ravindra Mohan; Vikram, Naval K.

doi:10.1155/2016/5160754

Cited by 19 publications

(20 citation statements)

References 30 publications

(40 reference statements)

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“…Heart rate variability was observed to be lower in individuals having NAFLD with and without diabetes compared to controls. These observations suggest that presence of NAFLD may be associated with autonomic dysfunction even in the absence of T2DM in Asian Indians 44 .…”

Section: Other Determinants/correlates Of Nafld In Asian Indiansmentioning

confidence: 64%

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

Bhatt¹,

Misra²,

Vikram

2017

Current Science

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Prevalence of non-alcoholic fatty liver disease (NAFLD) varies in India; up to one-third of the urban population is affected by the disease. In Asian Indians, presence of NAFLD is driven by multiple factorspresence of excess abdominal fat (abdominal subcutaneous and intra-abdominal fat) and lifestyle factors (imbalanced diets and physical inactivity), and it is correlated closely with insulin resistance, the metabolic syndrome and dysglycaemia in the background of genetic predisposition (investigated genes in Asian Indians: APOC3, PNPLA-3, PPAR, SREBP-2, adiponectin, SAMM50, PARVB and PZP). Recent studies also show that presence of NAFLD independently correlates with subclinical inflammation and surrogate markers of atherosclerosis (carotid intima-media thickness, impaired flow-mediated vasodilatation) in Asian Indians. A prediction equation (Indian Fatty Liver Index) which includes simple measures has been developed for Asian Indians. On the other hand, increased (more than 15.6 cm) liver span (surrogate marker of fatty liver), in a preliminary study, predicted diabetes in non-obese Asian Indians. Dietary factors are important for the development of NAFLD, and some evidence indicates that regular use of high monounsaturated fatty acid rich oils, and low amount of saturated fat intake are beneficial.

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Section: Other Determinants/correlates Of Nafld In Asian Indiansmentioning

confidence: 64%

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

Bhatt¹,

Misra²,

Vikram

2017

Current Science

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“…domain in subjects with NAFLD and diabetes [22]. This suggests that the occurrence of diabetes in NAFLD subjects worsens autonomic dysfunction.…”

Section: Plos Onementioning

confidence: 87%

Association of worsening of nonalcoholic fatty liver disease with cardiometabolic function and intestinal bacterial overgrowth: A cross-sectional study

et al. 2020

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Background & aims Non-alcoholic fatty liver disease (NAFLD) has been associated with small bowel bacterial overgrowth (SIBO) and cardiometabolic dysfunction. This cross-sectional study aimed to evaluate the cardio-metabolic parameters and SIBO in patients with different degrees of hepatic fibrosis estimated by NAFLD fibrosis score (NFS). Methods Subjects (n = 78) were allocated to three groups: Healthy control (n = 30), NAFLD with low risk of advanced fibrosis (NAFLD-LRAF, n = 17) and NAFLD with a high risk of advanced fibrosis (NAFLD-HRAF, n = 31). Anthropometrics, blood pressure, electrocardiogram and heart rate variability (HRV) were evaluated. Only the NAFLD-LRAF and NAFLD-HRAF groups were submitted to blood biochemical analysis and glucose hydrogen breath tests. Results The NAFLD-HRAF group had higher age and body mass index when compared to the control and NAFLD-LRAF groups. The prevalence of SIBO in the NAFLD group was 8.33%. The low frequency/high-frequency ratio (LF/HF ratio) was augmented in NAFLD-LRAF (p < 0.05) when compared with control group. NAFLD-HRAF group had a wide QRS complex (p < 0.05) and reduced LF/HF ratio (p < 0.05) compared to the control and NAFLD-LRAF groups. Serum levels of albumin and platelets were more reduced in the NAFLD-HRAF subjects (p < 0.05) than in the NAFLD-LRAF.

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“…HRV is known to contribute to complexity of the BF signal (Sassi et al, 2015;Wang et al, 2018) and HRV has been shown to be increased in obese individuals in whom there is a relative predominance of sympathetic activity in both the time and frequency domains (Rossi et al, 2015). HRV has also been shown to be increased in individuals with NAFLD (Kumar et al, 2016) independently of conventional cardiovascular risk factors and insulin resistance (Liu et al, 2013). Thus, it is possible that the down-rating of the association between cardiac power contribution and BF signal complexity was in part due to an increase in HRV.…”

Section: Discussionmentioning

confidence: 99%

Dysregulated Neurovascular Control Underlies Declining Microvascular Functionality in People With Non-alcoholic Fatty Liver Disease (NAFLD) at Risk of Liver Fibrosis

et al. 2020

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Background/Aims: Increasing evidence shows that non-alcoholic fatty liver disease (NAFLD) is associated with dysregulation of microvascular perfusion independently of established cardio-metabolic risk factors. We investigated whether hepatic manifestations of NAFLD such as liver fibrosis and liver fat are associated with microvascular hemodynamics through dysregulation of neurovascular control. Methods: Microvascular dilator (post-occlusive reactive hyperemia) and sympathetically mediated constrictor (deep inspiratory breath-hold) responses were measured at the forearm and finger, respectively, using laser Doppler fluximetry. Non-linear complexitybased analysis was used to assess the information content and variability of the resting blood flux (BF) signals, attributable to oscillatory flow-motion activity, and over multiple sampling frequencies. Results: Measurements were made in 189 adults (113 men) with NAFLD, with (n = 65) and without (n = 124) type 2 diabetes mellitus (T2DM), age = 50.9 ± 11.7 years (mean ± SD). Microvascular dilator and constrictor capacity were both negatively associated with age (r = −0.178, p = 0.014, and r = −0.201, p = 0.007, respectively) and enhanced liver fibrosis (ELF) score (r = −0.155, p = 0.038 and r = −0.418, p < 0.0001, respectively). There was no association with measures of liver fat, obesity or T2DM. Lempel-Ziv complexity (LZC) and sample entropy (SE) of the BF signal measured at the two skin sites were associated negatively with age (p < 0.01 and p < 0.001) and positively with ELF score (p < 0.05 and p < 0.0001). In individuals with an ELF score

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Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Cited by 19 publications

References 30 publications

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

Association of worsening of nonalcoholic fatty liver disease with cardiometabolic function and intestinal bacterial overgrowth: A cross-sectional study

Dysregulated Neurovascular Control Underlies Declining Microvascular Functionality in People With Non-alcoholic Fatty Liver Disease (NAFLD) at Risk of Liver Fibrosis

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