Vol 20, No 4 (2016)
REVIEW
Published online: 2016-12-29
Arterial hypertension, obesity and non-alcoholic fatty liver disease: is there any connection?
DOI: 10.5603/AH.2016.0025
Arterial Hypertension 2016;20(4):216-227.
Abstract
The combination of hypertension, obesity and non-alcoholic fatty liver disease occurs in medical practice very often. A number of studies have shown that non-alcoholic fatty liver disease increases the risk of cardiovascular disease independently of other predictors and manifestations of the metabolic syndrome. Current issues of research and identification of common pathogenic relationships of obesity, hypertension, and liver steatosis are investigated in the article. According to the analysed literature, it is indicated that insulin resistance and compensatory hyperinsulinaemia are considered as one of the key factors in the development of this comorbidity. The processes of chronic inflammation are increasing with the growth of adipose tissue volume. Some researchers believe that non-specific systemic inflammation combines arterial hypertension, increased body weight (especially abdominal obesity), steatosis, dyslipidaemia, atherogenesis and arteriosclerosis into a single syndrome. The role of non-alcoholic fatty liver disease in the growth of the thickness of the intima-media complex was studied. It is known that adipose tissue functions as an endocrine organ, expresses genes encoding bioactive substances, and secretes certain cytokines. A strong link between dysfunction of adipose tissue in patients with non-alcoholic fatty liver disease and in such conditions as metabolic syndrome and cardiovascular disease was demonstrated. The dysfunction of the endothelium is also advisable to consider as the connecting link between liver disease, obesity and hypertension. Despite some understanding of common pathogenic mechanisms for the development of non-alcoholic fatty liver disease and hypertension, this comorbid pathology remains the subject of much debate and a variety of studies.
Keywords: arterial hypertensionobesitynon-alcoholic fatty liver diseaseinsulin resistancedyslipidaemianon-specific systemic inflammationendothelial dysfunctionatherogenesis
References
- Korneeva EV. PREVENTIVE ACTION OF ORLISTAT ON CARDIOVASCULAR RISKS IN YOUNG OBESITY PATIENTS. Cardiovascular Therapy and Prevention. 2015; 14(4): 38–43.
- Deng WW, Wang J, Liu MM, et al. Body mass index compared with abdominal obesity indicators in relation to prehypertension and hypertension in adults: the CHPSNE study. Am J Hypertens. 2013; 26(1): 58–67.
- da Silva JP, Lima RP, de Carvalho Pereira D, et al. Association between waist-to-height ratio, isolated and combined morbidities and C-reactive protein in the elderly: a clinical-epidemiological study. Int J Environ Res Public Health. 2014; 11(9): 9595–9606.
- Lu Y, Hajifathalian K, Ezzati M, et al. Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects). Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet. 2014; 383(9921): 970–983.
- Komshilova KA. Abdominal obesity and non-alcoholic fatty liver disease: clinical, laboratory and morphological comparisons. Komshilova Kseniya Andreevna Moskva. 2015: 175.
- Kostyukevich OI. Arterial hypertension and liver disease: search of compromise. Russkiy meditsinskiy zhurnal. 2011; 5: 338–334.
- Drapkina OM, Popova IR. The role of obesity in the progression of hypertension and nonalcoholic fatty liver disease. Ukrayinskiy medichniy chasopis. 2013; 2: 125–128.
- Pasiyeshvili LM, Zheleznyakova NM, Pasiyeshvili TM. Nonalcoholic fatty liver disease and hypertension: pathogenetic factors of the formation and progression. Hastroenterolohiya. 2014; 2: 46–49.
- Wassertheil-Smoller S, Oberman A, Blaufox MD, et al. The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final results with regard to blood pressure, cardiovascular risk, and quality of life. Am J Hypertens. 1992; 5(1): 37–44.
- Kumanyika SK, Hebert PR, Cutler JA, et al. Feasibility and efficacy of sodium reduction in the Trials of Hypertension Prevention, phase I. Trials of Hypertension Prevention Collaborative Research Group. Hypertension. 1993; 22(4): 502–512.
- Grimm RH, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension. 1997; 29(1 Pt 1): 8–14.
- Rumberger JA, Brundage BH, Rader DJ, et al. Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc. 1999; 74(3): 243–252.
- Torgerson JS, Hauptman J, Boldrin MN, et al. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004; 27(1): 155–161.
- Babak O. Ya., Kolesnikova E.V., Dubrov K.Yu. Nonalcoholic steatohepatitis — “the accord” of methabolic disorders. Ukrayinskiy terapevtichniy zhurnal. 2011; 1: 5–11.
- Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology. 2012; 142(4): 711–725.e6.
- Velychko VI, Kolotvina LI. Hur’yeva A.M. Obesity and nonalcoholic fatty liver disease with cardiovascular risk positions in the practice of family physisions. Medytsyna transportu Ukrayiny. 2014; 1: 79–82.
- Gaskari SA, Honar H, Lee SS. Therapy insight: Cirrhotic cardiomyopathy. Nat Clin Pract Gastroenterol Hepatol. 2006; 3(6): 329–337.
- Yahmur VB. Nonalcoholic fatty liver disease: modern view of pathogenesis, diagnosis and treatment. Hastroenterologiya. 2013; 3: 138–147.
- Kolesnikova OV, Dubrov K. Yu., Krakhmalova E.O. Correlations of methabolic steatohepatitis, insulin resistance and anthropometric parameters in patients with symptoms of metabolic syndrome. Ukrayins’kyy terapevtychnyy zhurnal. 2010; 3: 81–86.
- Krahmalova EO, Kozlov AP. Nonalcoholic fatty liver disease and cardiovascular disease. The modern view on the problem. Ukrayins’kiy terapevtichnyi zhurnal. 2010; 4: 82–85.
- Prosolenko KO. Features of diagnosis and treatment of nonalcoholic fatty liver disease on the background of metabolic syndrome. Ukrayins’kyy terapevtychnyy zhurnal. 2010; 4: 86–92.
- KolesnIkova EV. Non-alcoholic fatty liver disease and hypertension: what we have achieved in the understanding of the problem. Ukrayinskiy medichniy chasopis. 2014; 3: 61–66.
- Hall JE, do Carmo JM, da Silva AA, et al. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015; 116(6): 991–1006.
- Kolesnikova OV. Yares’ko M.A. Hypertension and obesity in women during perimenopause, resolved and unresolved therapeutic problems. Ukrayins’kyy terapevtychnyy zhurnal. 2015; 3: 86–90.
- Abdou AS, Magour GM, Mahmoud MM. Evaluation of some markers of subclinical atherosclerosis in Egyptian young adult males with abdominal obesity. Br J Biomed Sci. 2009; 66(3): 143–147.
- Caserta CA, Pendino GM, Amante A, et al. Cardiovascular risk factors, nonalcoholic fatty liver disease, and carotid artery intima-media thickness in an adolescent population in southern Italy. Am J Epidemiol. 2010; 171(11): 1195–1202.
- Tarquini R, Lazzeri C, Boddi M, et al. [Non-alcoholic fatty liver disease: a new challenge for cardiologists]. G Ital Cardiol (Rome). 2010; 11(9): 660–669.
- Vlachopoulos C, Manesis E, Baou K, et al. Increased arterial stiffness and impaired endothelial function in nonalcoholic Fatty liver disease: a pilot study. Am J Hypertens. 2010; 23(11): 1183–1189.
- Oni ET, Agatston AS, Blaha MJ, et al. A systematic review: burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; should we care? Atherosclerosis. 2013; 230(2): 258–267.
- Andrés-Blasco I, Herrero-Cervera A, Vinué Á, et al. Hepatic lipase deficiency produces glucose intolerance, inflammation and hepatic steatosis. J Endocrinol. 2015; 227(3): 179–191.
- Athyros VG, Tziomalos K, Katsiki N, et al. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: An update. World J Gastroenterol. 2015; 21(22): 6820–6834.
- Lim S, Oh TJ, Koh KK. Mechanistic link between nonalcoholic fatty liver disease and cardiometabolic disorders. Int J Cardiol. 2015; 201: 408–414.
- Ponziani FR, Pecere S, Gasbarrini A, et al. Physiology and pathophysiology of liver lipid metabolism. Expert Rev Gastroenterol Hepatol. 2015; 9(8): 1055–1067.
- Adiels M, Taskinen MR, Packard C, et al. Overproduction of large VLDL particles is driven by increased liver fat content in man. Diabetologia. 2006; 49(4): 755–765.
- Lee S, Jin Kim Y, Yong Jeon T, et al. Obesity is the only independent factor associated with ultrasound-diagnosed non-alcoholic fatty liver disease: a cross-sectional case-control study. Scand J Gastroenterol. 2006; 41(5): 566–572.
- Seliverstov PV, Prihodko EM, Dobritsa VP, et al. Some issues of diagnosis, treatment and prevention of nonalcoholic fatty liver disease. Farmateka. 2015; 2: 49–55.
- Skybchyk VA, Voytovych MO. Nonalcoholic fatty liver disease: modern diagnostics. Hepatolohiya. 2015; 1: 52–56.
- Ghorbani A, Rafieian-Kopaei M, Nasri H. Lipoprotein (a): More than a bystander in the etiology of hypertension? A study on essential hypertensive patients not yet on treatment. J Nephropathol. 2013; 2(1): 67–70.
- Poynard T, Ngo Y, Perazzo H, et al. Prognostic value of liver fibrosis biomarkers: a meta-analysis. Gastroenterol Hepatol (N Y). 2011; 7(7): 445–454.
- Poynard T, Lassailly G, Diaz E, et al. FLIP consortium. Performance of biomarkers FibroTest, ActiTest, SteatoTest, and NashTest in patients with severe obesity: meta analysis of individual patient data. PLoS One. 2012; 7(3): e30325.
- Kleiner DE, Brunt EM. Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research. Semin Liver Dis. 2012; 32(1): 3–13.
- Grattagliano I, Ubaldi E, Napoli L, et al. Utility of noninvasive methods for the characterization of nonalcoholic liver steatosis in the family practice. The "VARES" Italian multicenter study. Ann Hepatol. 2013; 12(1): 70–77.
- Cauchy F, Fuks D, Zarzavadjian Le Bian A, et al. Metabolic syndrome and non-alcoholic fatty liver disease in liver surgery: The new scourges? World J Hepatol. 2014; 6(5): 306–314.
- Zhuravlyova AK, Bobronnikova LR. Predictors of fibrozis in patients with combination of non-alcoholic fatty liver disease and type 2 diabetes. Endokrinologiya. 2014; 19: 134–140.
- AlShaalan R, Aljiffry M, Al-Busafi S, et al. Nonalcoholic fatty liver disease: Noninvasive methods of diagnosing hepatic steatosis. Saudi J Gastroenterol. 2015; 21(2): 64–70.
- Cheng S, Wiklund P, Autio R, et al. Adipose Tissue Dysfunction and Altered Systemic Amino Acid Metabolism Are Associated with Non-Alcoholic Fatty Liver Disease. PLoS One. 2015; 10(10): e0138889.
- Stefan N, Schäfer S, Machicao F, et al. Liver fat and insulin resistance are independently associated with the -514C>T polymorphism of the hepatic lipase gene. J Clin Endocrinol Metab. 2005; 90(7): 4238–4243.
- Kobylyak NM, Dynnyk OB, Kyriyenko DV. Current approaches to diagnosis and screening of metabolic disorders in patients with nonalcoholic fatty liver disease. Mizhnarodnyy endokrynolohichnyy zhurnal. 2015; 5: 89–99.
- Stepanov YM. Hepatic steatosis and steatohepatitis — the inevitability of mixed origin. Hastroenterolohyya. 2014; 4: 136–142.
- Cankurtaran M, Tayfur O, Yavuz BB, et al. Insulin resistance and metabolic syndrome in patients with NAFLD but without diabetes: effect of a 6 month regime intervention. Acta Gastroenterol Belg. 2007; 70(3): 253–259.
- Babak OY, Kolesnikova EV. Pathogenic mechanisms of non-alcoholic fatty liver disease: a focus on clinical application of ademetionin. Suchasna gastroenterologiya. 2011; 3: 56–63.
- Oganov RG, Perova NV, Shchel'tsyna NV, et al. [Signs of metabolic syndrome in combinations of hypertension with coronary risk factors]. Kardiologiia. 2005; 45(7): 27–33.
- Khukhlina OS. Fatty liver disease: etiology, epidemiology, course features, diagnosis, prognosis. Ukrayins’kyy medychnyy chasopys. 2006; 1: 89–95.
- Fallo F, Dalla Pozza A, Sonino N, et al. Nonalcoholic fatty liver disease, adiponectin and insulin resistance in dipper and nondipper essential hypertensive patients. J Hypertens. 2008; 26(11): 2191–2197.
- Latea L, Negrea S, Bolboaca S. Primary non-alcoholic fatty liver disease in hypertensive patients. Australas Med J. 2013; 6(6): 325–330.
- Steffen H, Demir M, Lang S, et al. High rate of undetected arterial hypertension in patients with non-alcoholic steatohepatitis (NASH). J Hypertens. 2010; 28: 557.
- Khukhlina OS, Mandryk O. Ye., Antoniv A. A., Nechypay Zh. A. diagnostic markers of liver fibrosis in patients with fatty liver disease, combined with hypertension and obesity. Visnyk problem biolohiyi ta medytsyny. 2013; 3: 250–253.
- Perticone M, Cimellaro A, Maio R, et al. Endothelial dysfunction and non-alcoholic liver steatosis in hypertensive patients. Nutr Metab Cardiovasc Dis. 2011; 21(7): 485–491.
- Angelico F, Del Ben M, Conti R, et al. Insulin resistance, the metabolic syndrome, and nonalcoholic fatty liver disease. J Clin Endocrinol Metab. 2005; 90(3): 1578–1582.
- Bugianesi E, Gastaldelli A, Vanni E, et al. Insulin resistance in non-diabetic patients with non-alcoholic fatty liver disease: sites and mechanisms. Diabetologia. 2005; 48(4): 634–642.
- Hamaguchi M, Kojima T, Takeda N, et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med. 2005; 143(10): 722–728.
- Abdelmalek MF, Diehl AM. Nonalcoholic fatty liver disease as a complication of insulin resistance. Med Clin North Am. 2007; 91(6): 1125–1149.
- Chang CY, Argo CK, Al-Osaimi AMS, et al. Therapy of NAFLD: antioxidants and cytoprotective agents. J Clin Gastroenterol. 2006; 40 Suppl 1: S51–S60.
- Lall CG, Aisen AM, Bansal N, et al. Nonalcoholic fatty liver disease. AJR Am J Roentgenol. 2008; 190(4): 993–1002.
- Targher G, Bertolini L, Zoppini G, et al. Increased plasma markers of inflammation and endothelial dysfunction and their association with microvascular complications in Type 1 diabetic patients without clinically manifest macroangiopathy. Diabet Med. 2005; 22(8): 999–1004.
- Shevchuk VV, Fediv OI. Changes of oxidative and proxidative homeostasis in nonalcoholic steatohepatitis in patients with metabolic syndrome. Visnyk problem biolohiyi ta medytsyny. 2013; 3: 276–278.
- Radchenko VG, Seliverstov PV. Non-alcoholic fatty liver disease: new treatment options. Usovershenstvovannaya meditsinskaya tehnologiya. 2014: 11–20.
- Graham I, Cooney MT, Bradley D, et al. Dyslipidemias in the prevention of cardiovascular disease: risks and causality. Curr Cardiol Rep. 2012; 14(6): 709–720.
- Kotronen A, Peltonen M, Hakkarainen A, et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009; 137(3): 865–872.
- Go Gw. Low-Density Lipoprotein Receptor-Related Protein 6 (LRP6) Is a Novel Nutritional Therapeutic Target for Hyperlipidemia, Non-Alcoholic Fatty Liver Disease, and Atherosclerosis. Nutrients. 2015; 7(6): 4453–4464.
- Miyazaki M, Flowers MT, Sampath H, et al. Hepatic stearoyl-CoA desaturase-1 deficiency protects mice from carbohydrate-induced adiposity and hepatic steatosis. Cell Metab. 2007; 6(6): 484–496.
- Cai A, Li L, Zhang Y, et al. Lipoprotein(a): a promising marker for residual cardiovascular risk assessment. Dis Markers. 2013; 35(5): 551–559.
- Maranhão RC, Carvalho PO, Strunz CC, et al. Lipoprotein (a): structure, pathophysiology and clinical implications. Arq Bras Cardiol. 2014; 103(1): 76–84.
- Schwenzer NF, Springer F, Schraml C, et al. Non-invasive assessment and quantification of liver steatosis by ultrasound, computed tomography and magnetic resonance. J Hepatol. 2009; 51(3): 433–445.
- Pasiyeshvili LM, Khoroshavina TF. Immune imbalance as the basis of the progression of steatohepatitis in patients with hypertension and obesity. Ukrayins’kyy terapevtychnyy zhurnal. 2014; 2: 40–44.
- Chumak AA, Ovsyannikova LM, Kubashko AV, et al. Features of the molecular mechanisms of nonalcoholic fatty liver disease progression. Ukrayins’kyy medychnyy chasopys. 2013; 6: 33–39.
- Babak O. Ya., Klimenko N. N. Physiological and pathophysiological role of adiponectin in the complex regulation of the metabolism and the development of cardiovascular diseases. Ukrayinskiy terapevtichniy zhurnal. 2010; 2: 94–100.
- Dschietzig T, Brecht A, Bartsch C, et al. Relaxin improves TNF-α-induced endothelial dysfunction: the role of glucocorticoid receptor and phosphatidylinositol 3-kinase signalling. Cardiovasc Res. 2012; 95(1): 97–107.
- Kravchenko NA, Klimenko NN. Mechanisms of development of cardio-metabolic syndrome in obesity. Problemi endokrinnoyi patologiyi. 2012; 1: 84–93.
- Kovalenko VM, Talayeva TV, Kozlyuk AS. Metabolic syndrome: as a factor in cardiovascular risk: mechanisms of progression the principles of diagnosis and treatment. Ukrayins’kyy kardiolohichnyy zhurnal. 2013; 5: 80–87.
- McMaster WG, Kirabo A, Madhur MS, et al. Inflammation, immunity, and hypertensive end-organ damage. Circ Res. 2015; 116(6): 1022–1033.
- Wozniak SE, Gee LL, Wachtel MS, et al. Adipose tissue: the new endocrine organ? A review article. Dig Dis Sci. 2009; 54(9): 1847–1856.
- Estep JM, Baranova A, Hossain N, et al. Expression of cytokine signaling genes in morbidly obese patients with non-alcoholic steatohepatitis and hepatic fibrosis. Obes Surg. 2009; 19(5): 617–624.
- Sur G, Floca E, Kudor-Szabadi L, et al. The relevance of inflammatory markers in metabolic syndrome. Maedica (Buchar). 2014; 9(1): 15–18.
- Dubielski Z, Zamojski M, Wiechecki B, et al. The current state of knowledge about the dipping and non-dipping hypertension. Arterial Hypertension. 2016; 20(2): 33–43.
- Hall JE, da Si, Brandon E. Pathophysiology of obesity hypertension and target organ injury. In: Lip GYP, Hall JE. ed. Comprehensive Hypertension. Elsevier, New York 2007: 447–468.
- Anty R, Lemoine M. Liver fibrogenesis and metabolic factors. Clin Res Hepatol Gastroenterol. 2011; 35 Suppl 1: S10–S20.
- Gnacińska M, Małgorzewicz S, Lysiak-Szydłowska W, et al. The serum profile of adipokines in overweight patients with metabolic syndrome. Endokrynol Pol. 2010; 61(1): 36–41.
- Lemoine M, Ratziu V, Kim M, et al. Serum adipokine levels predictive of liver injury in non-alcoholic fatty liver disease. Liver Int. 2009; 29(9): 1431–1438.
- Day CP. From fat to inflammation. Gastroenterology. 2006; 130(1): 207–210.
- Harwood HJ. The adipocyte as an endocrine organ in the regulation of metabolic homeostasis. Neuropharmacology. 2012; 63(1): 57–75.
- Parfenov NS. Tanyanskyy D. A. Adiponectin: befenit influencce on the metabolic and cardio-vascular disorders. Arteryal’naya hypertenzyya. 2013; 1: 84–96.
- Dogru T, Genc H, Tapan S, et al. Plasma fetuin-A is associated with endothelial dysfunction and subclinical atherosclerosis in subjects with nonalcoholic fatty liver disease. Clin Endocrinol (Oxf). 2013; 78(5): 712–717.
- Wild SH, Byrne CD, Tzoulaki I, et al. Metabolic syndrome, haemostatic and inflammatory markers, cerebrovascular and peripheral arterial disease: The Edinburgh Artery Study. Atherosclerosis. 2009; 203(2): 604–609.
- Kalhan SC, Guo L, Edmison J, et al. Plasma metabolomic profile in nonalcoholic fatty liver disease. Metabolism. 2011; 60(3): 404–413.
- Villanova N, Moscatiello S, Ramilli S, et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology. 2005; 42(2): 473–480.
- Yarmysh NV, Hroznaya LN. Endothelial dysfunction and its regulatory factors. Visnyk problem biolohiyi ta medytsyny. 2014; 3: 37–43.
- Mitchenko OI. Kornats’ka A.H., Romanov V.Yu., Sopko O.V. Endothelial function and thickness of intima — media in women with metabolic syndrome on the background of polycystic ovaries. Ukrayins’kyy kardiolohichnyy zhurnal. 2013; 3: 82–89.
- Bahcecioglu IH, Yalniz M, Ataseven H, et al. Levels of serum hyaluronic acid, TNF-alpha and IL-8 in patients with nonalcoholic steatohepatitis. Hepatogastroenterology. 2005; 52(65): 1549–1553.
- Arias IM, Boyer JL, Chisari FV. The liver: Biology and pathobiology. Lippincott Williams & Wilkins, Philadelphia 2001: 437–453.
- Pasarín M, La Mura V, Gracia-Sancho J, et al. Sinusoidal endothelial dysfunction precedes inflammation and fibrosis in a model of NAFLD. PLoS One. 2012; 7(4): e32785.
- Miyao M, Kotani H, Ishida T, et al. Pivotal role of liver sinusoidal endothelial cells in NAFLD/NASH progression. Lab Invest. 2015; 95(10): 1130–1144.
- Fan Yu, Wei F, Zhou Y, et al. Association of non-alcoholic fatty liver disease with impaired endothelial function by flow-mediated dilation: A meta-analysis. Hepatol Res. 2016; 46(3): E165–E173.
- Long MT, Wang Na, Larson MG, et al. Nonalcoholic fatty liver disease and vascular function: cross-sectional analysis in the Framingham heart study. Arterioscler Thromb Vasc Biol. 2015; 35(5): 1284–1291.
- Schindhelm RK, Diamant M, Bakker SJL, et al. Liver alanine aminotransferase, insulin resistance and endothelial dysfunction in normotriglyceridaemic subjects with type 2 diabetes mellitus. Eur J Clin Invest. 2005; 35(6): 369–374.
- Fracanzani AL, Valenti L, Bugianesi E, et al. Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology. 2008; 48(3): 792–798.
- Katsiki N, Mikhailidis DP. Emerging Vascular Risk Factors in Women: Any Differences from Men? Curr Med Chem. 2015; 22(31): 3565–3579.
- Cai J, Zhang S, Huang W. Association between nonalcoholic fatty liver disease and carotid atherosclerosis: a meta-analysis. Int J Clin Exp Med. 2015; 8(5): 7673–7678.
- Brea A, Mosquera D, Martín E, et al. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis: a case-control study. Arterioscler Thromb Vasc Biol. 2005; 25(5): 1045–1050.
- Rubin J, Nambi V, Chambless LE, et al. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC (Atherosclerosis Risk In Communities) study. J Am Coll Cardiol. 2010; 55(15): 1600–1607.
- Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging. 2014; 7(10): 1025–1038.
- Kuzminova N, Osovska N, Lozinsky S, et al. Characteristics of changes and clinical and instrumental predictors of the severity of structural remodelling of carotid arteries in hypertensive patients. Arterial Hypertension. 2016; 20(2): 60–67.
- Yingchoncharoen T, Limpijankit T, Jongjirasiri S, et al. Arterial stiffness contributes to coronary artery disease risk prediction beyond the traditional risk score (RAMA-EGAT score). Heart Asia. 2012; 4(1): 77–82.
- Brant L, Hamburg NM, Barreto SM, et al. Relations of Digital Vascular Function, Cardiovascular Risk Factors, and Arterial Stiffness: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Cohort Study. Journal of the American Heart Association. 2014; 3(6): e001279.
- Chou CY, Yang YC, Wu JS, et al. Non-alcoholic fatty liver disease associated with increased arterial stiffness in subjects with normal glucose tolerance, but not pre-diabetes and diabetes. Diab Vasc Dis Res. 2015; 12(5): 359–365.
- Lee YJ, Shim JY, Moon BS, et al. The relationship between arterial stiffness and nonalcoholic fatty liver disease. Dig Dis Sci. 2012; 57(1): 196–203.
- Yu Xy, Zhao Yi, Song Xx, et al. Association between non-alcoholic fatty liver disease and arterial stiffness in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population. J Zhejiang Univ Sci B. 2014; 15(10): 879–887.
- Ozturk K, Kurt O, Dogan T, et al. Pentraxin 3 Is a Predictor for Fibrosis and Arterial Stiffness in Patients with Nonalcoholic Fatty Liver Disease. Gastroenterol Res Pract. 2016; 2016: 1417962.
- Pierce GL, Zhu H, Darracott K, et al. Arterial stiffness and pulse-pressure amplification in overweight/obese African-American adolescents: relation with higher systolic and pulse pressure. Am J Hypertens. 2013; 26(1): 20–26.
- Dzyak GV, Kolesnik EL. Vascular wall stiffness and atherosclerotic changes of carotid arteries in men suffering from hypertension. Ukrayinskiy terapevtichniy zhurnal. 2015; 2: 16–23.
- Chung GE, Choi SY, Kim D, et al. Nonalcoholic fatty liver disease as a risk factor of arterial stiffness measured by the cardioankle vascular index. Medicine (Baltimore). 2015; 94(12): e654.
- Lewis JR, Mohanty SR. Nonalcoholic fatty liver disease: a review and update. Dig Dis Sci. 2010; 55(3): 560–578.