PRIMARY NON ALCOHOLIC FATTY LIVER DISEASE IN HYPERTENSIVE PATIENTS
Abstract:
The aim of the present study was to investigate the prevalence of NAFLD and the relationship
between insulin sensitivity and NAFLD in grade III high and very high cardiovascular additional risk
essential hypertensive patients according to the circadian blood pressure (BP) rhythm. This four years
prospective study conducted at the Departament of Internal Medicine from the Diagnosis and Treatment
Center from Cluj-Napoca. The study included grade III essential hypertensive patients. Hypertensive
patients were divided into four groups: dipper(D), non-dipper (ND), reverse-dipper (RD), extremedipper
(ED) according the diurnal index (DI) from ABPM monitoring. All hypertensive patients
underwent 24 hour ambulatory blood pressure monitoring (ABPM) (for systolic and diastolic blood
pressure evaluation), blood tests and abdominal ultrasonography for the diagnosis of fatty liver disease.
Thirty five hypertensive patients were included in the study, a number of 31.42% ND, 11.43% RD,
8.57% ED and 48.57% D. The prevalence of NAFLD was significantly higher in ND, RD, ED compared
to D. When compared to dipper group of hypertensive patients a statistically significantly higher level of
plasma insulin was observed in the group of non-dipper (86.3±17.9pmol/l vs. 62.2±203pmol/l, p<0.05),
in reverse dipper (88.3±18.6pmol/l vs. 62.2±20.3pmol/l) in extreme-dippers (86.7±16.88pmol/l vs.
62.2±20.3 pmol/l, p<0.05). The altered dipping status (ND, RD, ED) of hypertension associated a
higher insulin resistance that could be the pathogenetic link between the NAFLD and altered blood
pressure status. Altered blood pressure status could be a marker of NAFLD in hypertensive patients.
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