NEUROHUMORAL DISORDERS IN PATIENTS WITH CHRONIC CORONARY SYNDROME COMORBID WITH NON-ALCOHOLIC FATTY LIVER DISEASE
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i3.12526Keywords:
chronic coronary syndrome, non-alcoholic fatty liver disease, adiponectin, resistin, insulin, asymmetric dimethylarginine, C-reactive proteinAbstract
Non-alcoholic fatty liver disease is considered to be one of the conditions associated with the metabolic syndrome, which significantly worsens the course of chronic coronary syndrome (CCS).
The aim – to study the levels of adipocytokines, markers of systemic inflammation and endothelial dysfunction and their relationship with the clinical course of ACS, comorbid with non-alcoholic fatty liver disease (NAFLD).
Material and Methods. The prospective monocenter double open study in parallel groups involved 120 patients with CCS: stable angina pectoris II-III functional class aged 60.0 (55.0; 64.0) years, of whom 67 (55 %) men and 53 (45 %) women. The control selected group included 30 healthy individuals aged 59.0 (58.0; 66.0) years, including 14 (46 %) men and 16 (54 %) women. Determination of the serum concentration of biomarkers (adiponectin, resistin, insulin, asymmetric dimethylarginine (ADMA), C-reactive protein) was performed using enzyme-linked immunosorbent assay.
Results. In patients with CCS combined with NAFLD, the derived levels of biomarkers significantly (p <0.05) differed from the control selected group: the concentration of resistin was 48 % higher, adiponectin 60 % lower; there was an increase in the content of CRP (by 8.9 times) and ADMA (by 42 %). In patients with CCS without liver pathology, the levels of adiponectin and resistin did not significantly exceed those in healthy individuals, but there were significantly higher levels of CRP (by 3.1 times) and ADMA (by 30 %). In patients with CCS combined with NAFLD, if compared to patients with CCS without structural and functional pathology of the liver, a significant (p<0.05) decrease in adiponectin level by 31.6 %, an increase in resistin level by 27 %, ADMA level by 21 % and CRP level by 2.81 times was observed. In patients with nonalcoholic steatohepatitis (NASH), the activity of systemic inflammation was significantly higher if compared to patients with steatosis, which was confirmed by an increase in CRP concentration by 44 % (p <0.05). The identified correlations reflect the existing relationship between the functional state of the liver and metabolic, neurohumoral disorders.
Conclusions. In patients with CCS associated with NAFLD, there is an imbalance of adipocytokines (decrease in adiponectin concentration, increase in resistin levels and decrease in the ratio of adiponectin to resistin) compared with the control selected group and in patients with CCS without liver pathology. Significant increases in serum levels of ADMA and CRP indicate the presence of endothelial dysfunction on the background of activation of systemic inflammation and may indicate the pathogenetic significance of these markers in the development and progression of CCS on the background of NAFLD.
References
Chekalina, N.I. (2020). Hendernyi analiz pokaznykiv khronichnoho systemnoho zapalennia u khvorykh na ishemichnu khvorobu sertsia [Gender analysis of chronic systemic inflammation indicators in patients with ischemic heart disease] Visnyk problem biolohii i medytsyny – Bulletin of Problems of Biology and Medicine, 3 (157), 161-165 [in Ukrainian].
Jurisch, D., & Laufs, U. (2021). Chronisches Koronarsyndrom : Neuklassifikation der stabilen koronaren Herzkrankheit. Der Internist, 62(1), 47-57. https://doi.org/10.1007/s00108-020-00910-0
Virstiuk, N.H., & Vakaliuk, I.I. (2017). Vplyv sposobu zhyttia na perebih nealkoholnoi zhyrovoi khvoroby pechinky u patsiientiv zi stabilnoiu ishemichnoiu khvoroboiu sertsia [The influence of lifestyle on the course of non-alcoholic fatty liver disease in patients with stable coronary heart disease]. Ukr. med. Chasopys – Ukr. Med. Magazine, 2, 113 - 116 [in Ukrainian].
Babinets, L.S., & Kytsai, K.Iu., (2021). Vzaiemozalezhnist stanu pechinky i pidshlunkovoi zalozy pry khronichnomu biliarnomu pankreatyti na tli ozhyrinnia. Pidkhody do kompleksnoho likuvannia [Interdependence of the state of the liver and pancreas in chronic biliary pancreatitis on the background of obesity. Approaches to complex treatment]. Suchasna hastroenterolohiia – Modern Gastroenterology, 1(117), 5-11 [in Ukrainian].
Do, A., & Lim, J.K. (2016). Epidemiology of nonalcoholic fatty liver disease: A primer. Clinical Liver Disease, 7(5), 106-108. https://doi.org/10.1002/cld.547
Stepanov, Yu.M., & Filippova, O.Yu., (2020). Evoliutsiia uiavlen pro nealkoholnu zhyrovu khvorobu pechinky: vid ryzyku do katastrofy [Evolving ideas on non-alcoholic fatty liver disease: from risk to catastrophe]. Zaporozhskyi medytsynskyi zhurnal – Zhaporizhzhia Medical Journal, 22, 2(119), 267-274 [in Ukrainian].
Stepanov, Yu.M., Nedzvetska, N.V., Yahmur, V.,B., & Klenina, I.A. (2018). Nealkoholna zhyrova khvoroba pechinky: osoblyvosti metabolichnykh zmin na riznykh etapakh rozvytku khvoroby [Non-alcoholic fatty liver disease: features of metabolic changes at different stages of the disease]. Hastroenterohlohiya – Gastroenterology, 1, 52(1), 1-6 [in Ukrainian].
Mykhailovska, N.S., & Miniailenko, L.Ie. (2016). Vzaiemozviazok nealkoholnoi zhyrovoi khvoroby pechinky z komponentamy metabolichnoho syndromu u khvorykh na ishemichnu khvorobu sertsia. [Relationship of nonalcoholic fatty liver disease with components of metabolic syndrome in patients with ischemic heart disease]. Bukovynskyi med. Visnyk – Bukovinian Med. Bulletin, 1 (77), 79-83 [in Ukrainian].
Yang, R.X., Zou, Z.S., Zhong, B.H., Deng, H., He, F.P., Shi, J.P., Zhao, C.Y., Mi, Y.Q., Zhou, Y.J., Di, F.S., Zheng, R.D., Du, Q., Shang, J., Popovic, B., Chen, J., & Fan, J.G. (2021). The pathologic relevance of metabolic criteria in patients with biopsy-proven non-alcoholic fatty liver disease and metabolic dysfunction associated fatty liver disease: A multicenter cross-sectional study in China. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 1499-3872(21)00112-0. Advance online publication. https://doi.org/10.1016/j.hbpd.2021.06.002
Benedict, M., & Zhang, X. (2017). Non-alcoholic fatty liver disease: An expanded review. World Journal of Hepatology, 9(16), 715-732. https://doi.org/10.4254/wjh.v9.i16.715
Mykhailovska, N.S., & Miniailenko, L.E. (2017). Vascular endothelium state, clinical and metabolic features of patients with coronary heart disease combined with nonalcoholic fatty liver disease. Patolohiia – Pathology, 1, 62-67 [in Ukrainian].
Dongiovanni, P., Paolini, E., Corsini, A., Sirtori, C.R., & Ruscica, M. (2021). Nonalcoholic fatty liver disease or metabolic dysfunction-associated fatty liver disease diagnoses and cardiovascular diseases: From epidemiology to drug approaches. European Journal of Clinical Investigation, 51(7), e13519. https://doi.org/10.1111/eci.13519
Tkach, S.M., & Cheverda, T.L. (2016). Nealkoholna zhyrova khvoroba pechinky: poshyrenist, pryrodnyi perebih, suchasni pidkhody do diahnostyky ta likuvannia. [Non-alcoholic fatty liver disease: incidence, natural history, new approaches to diagnostic and treatment]. Klinichna endokrynolohiia ta endokrynna khirurhiia – Clinical Endocrinology and Endocrine Surgery, 1, 60-71 [in Ukrainian].
Achari, A.E., & Jain, S.K. (2017). Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. International Journal of Molecular Sciences, 18(6), 1321. https://doi.org/10.3390/ijms18061321
Shabalala, S.C., Dludla, P.V., Mabasa, L., Kappo, A.P., Basson, A.K., Pheiffer, C., & Johnson, R. (2020). The effect of adiponectin in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and the potential role of polyphenols in the modulation of adiponectin signaling. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 131, 110785. https://doi.org/10.1016/j.biopha.2020.110785
Forlano, R., Mullish, B.H., Nathwani, R., Dhar, A., Thursz, M.R., & Manousou, P. (2021). Non-Alcoholic Fatty Liver Disease and Vascular Disease. Current Vascular Pharmacology, 19(3), 269-279. https://doi.org/10.2174/1570161118666200318103001
Cziráki, A., Lenkey, Z., Sulyok, E., Szokodi, I., & Koller, A. (2020). L-Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice. Frontiers in Pharmacology, 11, 569914. https://doi.org/10.3389/fphar.2020.569914
Zhang, H., Niu, Y., Gu, H., Lu, S., Zhang, W., Li, X., Yang, Z., Qin, L., & Su, Q. (2019). Low serum adiponectin is a predictor of progressing to nonalcoholic fatty liver disease. Journal of Clinical Laboratory Analysis, 33(3), e22709. https://doi.org/10.1002/jcla.22709
Feldman, A., Eder, S.K., Felder, T.K., Paulweber, B., Zandanell, S., Stechemesser, L., Schranz, M., Strebinger, G., Huber-Schönauer, U., Niederseer, D., Patsch, W., Weghuber, D., Tevini, J., Datz, C., & Aigner, E. (2019). Clinical and metabolic characterization of obese subjects without non-alcoholic fatty liver: A targeted metabolomics approach. Diabetes & Metabolism, 45(2), 132-139. https://doi.org/10.1016/j.diabet.2018.09.003
Tepliakov, A.T., Akhmedov, Sh.D., & Suslova, T.E. (2015). Vlyianye rezystyna na techenye yshemycheskoi bolezny serdtsa u patsyentov s sakharnыm dyabetom 2-ho typa [Effect of resistin on the course of ischemic heart disease in patients with type 2 diabetes mellitus] Biul.syb. medytsyny – Bul. Sib. Medicine., 14 (5), 73-82 [in Russian].
Wen, F., Shi, Z., Liu, X., Tan, Y., Wei, L., Zhu, X., Zhang, H., Zhu, X., Meng, X., Ji, W., Yang, M., & Lu, Z. (2021). Acute Elevated Resistin Exacerbates Mitochondrial Damage and Aggravates Liver Steatosis Through AMPK/PGC-1Signaling Pathway in Male NAFLD Mice. Hormone and Metabolic Research = Hormon- und Stoffwechselforschung = Hormones et Metabolisme, 53(2), 132-144. https://doi.org/10.1055/a-1293-8250
Hill, M.A., Yang, Y., Zhang, L., Sun, Z., Jia, G., Parrish, A.R., & Sowers, J.R. (2021). Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism: Clinical and Experimental, 119, 154766. https://doi.org/10.1016/j.metabol.2021.154766
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Achievements of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
