Non-Alkolik Yağlı Karaciğer Hastalarında Kardiyovasküler Riski Kolayca Tahmin Etmek Mümkün mü?

Year 2024, Volume: 34 Issue: 5, 629 - 636, 31.10.2024

Hakan Ozer , İsmail Baloğlu , Yasin Öztürk , Necdet Poyraz , Kültigin Türkmen

https://doi.org/10.54005/geneltip.1415989

Abstract

Amaç: Enflamasyon, alkolsüz yağlı karaciğer hastalığının (NAYKH) patogenezinde önemli bir rol oynar. Epikardiyal yağ dokusu (EYD), enflamatuar hücrelerle yakından ilişkilidir. Monosit sayısının HDL-kolesterol'e (MHR) oranı, kardiyovasküler hastalık (KVH) için yeni bir prognostik belirteçtir. NAYKH hastalarında EYD ile inflamatuvar göstergeler arasındaki ilişkiyi ve bunun basit testlerle tahmin edilip edilemeyeceğini araştırmak istedik.
Gereç-Yöntem: Bu retrospektif çalışmaya 2014-2021 yılları arasında toraks bilgisayarlı tomografi anjiyografisi yapılan 218 hasta dahil edildi. Hastalar karaciğer atenüasyon oranına göre NAYKH grubu (HU<48 IU) ve NAYKH olmayan grup (HU>48 IU) olarak ayrıldı. NAYKH grubunda 136 hasta ve NAYKH olmayan grupta 82 hasta.
Bulgular: NAYKH grubunun vücut kitle indeksi (VKİ), trigliserit, EYD hacmi ve MHR değerleri diğer grutan yüksekti. NAYKH grubunda EYD hacmi, yaş, MHR, c-reaktif protein (CRP), VKI, üre, glikoz ve alanin aminotransferaz (ALT) ile pozitif korelasyon gösterdi. Lineer regresyon analizinde MHR, NAFLD hastalarında EYD hacminin tek bağımsız belirleyicisiydi.
Sonuç: KVH için bir risk belirteci olan EYD hacmi, NAYKH hastalarında radyolojik yöntemler olmaksızın MHR ile tahmin edilebilir. Böylece KVH açısından yüksek risk grubunda yer alan NAYKH hastalarının daha kolay ve erken saptanması mümkün olacaktır.

Keywords

Epikardial yağ dokusu, kardiyovaskuler hastalık, monosit-HDL oranı, nonalkolik yaplı karaciğer hastalığı, inflamasyon

Can Cardiovascular Risk Be Simply Estimated in Nonalcoholic Fatty Liver Disease Patients?

Abstract

Backgrounds and Aims: In the pathogenesis of nonalcoholic fatty liver disease (NAFLD), inflammation plays a pivotal role. The presence of inflammatory cells is closely linked with epicardial adipose tissue (EAT). A recently identified prognostic indicator for cardiovascular disease (CVD) is the ratio of monocyte count to HDL-cholesterol (MHR). Our primary aim was to investigate the relationship between EAT and markers of inflammation in individuals with NAFLD, and to evaluate its predictability using straightforward diagnostic measures.
Material-Method: This retrospective study included two hundred eighteen patients who underwent thoracic computed tomography angiography between 2014 and 2021. The patients were divided into the NAFLD group (HU<48 IU) and the non-NAFLD group (HU>48 IU) according to the liver attenuation ratio. 136 patients in the NAFLD group and 82 in the non-NAFLD group.
Results: The body mass index (BMI), triglyceride levels, notably the EAT volume and MHR in the NAFLD group, exhibited higher values than non-NAFLD group. Among participants in the NAFLD group, a positive correlation was observed between EAT volume and factors such as age, MHR, c-reactive protein, BMI, urea, glucose, and alanine aminotransferase. Through linear regression analysis, it was determined that MHR stood as the sole independent predictor of EAT volume in patients with NAFLD.
Conclusion: EAT volume, a risk marker for CVD, can be predicted in NAFLD patients by MHR without radiological methods. Thus, easier and earlier detection of NAFLD patients in the high-risk group for CVD will be possible.

Keywords

Epicardial adipose tissue, cardiovascular disease, monocyte-HDL ratio, nonalcoholic fatty liver disease, inflammation

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