7 Several studies 8- 19 have shown that patients with NAFLD were significantly associated with endothelial dysfunction compared with the controls. 5, 6 The measurement of flow-mediated dilation (FMD) in the brachial artery is the most common method for determination of vascular endothelial function. Impaired endothelial function occurs during the early course of atherosclerosis. 3, 4 Therefore, the early identification and management of these cardiovascular risks would help reduce NAFLD-related complications.Įndothelial dysfunction usually refers to the impairment of endothelial-dependent vasodilatation. 2 More importantly, NAFLD patients were associated with a greater risk of all-cause mortality in the general population because of cardiovascular causes. 1 NAFLD increases the risk of subclinical atherosclerosis and coronary artery disease. Its histological abnormalities range from simple steatosis to non-alcoholic steatohepatitis (NASH), which may progress to liver fibrosis and cirrhosis. Non-alcoholic fatty liver disease (NAFLD) is the most common public health concern worldwide. Assessment of endothelial function may be recommended to identify subclinical atherosclerosis and to create subgroups of non-alcoholic fatty liver disease patients who are at higher risk of future cardiovascular events. Non-alcoholic fatty liver disease is associated with a greater risk of endothelial dysfunction as indicated by the decreased brachial artery flow-mediated dilation. However, no significant differences were observed in the nitrate-induced dilation (weighted mean difference, –0.4% 95% confidence interval, –2.19 to 1.39). Subgroup analysis indicated that the patients with non-alcoholic steatohepatitis or a body mass index of more than 30 kg/m 2 appeared to have a greater reduction in their flow-mediated dilation. Meta-analysis indicated that non-alcoholic fatty liver disease patients were associated with a reduction in brachial artery flow-mediated dilation (weighted mean difference, –4.82% 95% confidence interval, –5.63 to –4.00) compared with the healthy controls. ResultsĮleven observational studies were identified. Endothelial function was measured by brachial artery flow-mediated dilation and nitrate-induced dilatation techniques. All observational studies that compared endothelial function between non-alcoholic fatty liver disease patients and healthy controls were included. We systematically searched through the PubMed, Embase, China National Knowledge Infrastructure and Wanfang databases for studies dated up to January 2015. The aim of the present study was to evaluate the extent of endothelial function impairment in patients with non-alcoholic fatty liver disease. Endothelial dysfunction was observed in patients with non-alcoholic fatty liver disease.
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