The relationship between renal function and blood pressure with nafld

Non-alcoholic fatty liver disease is the accumulation of fat in the liver. With this accumulation,it is shown that the mass of the liver increased by 5 to 10%. This pathology has a wide sprectrum of diseases-from simple steatosis to steatohepatitis and cirrhosis (15-17). It is suggested that non-alcoholic fatty liver disease may be the main cause of all hepatic diseases; moreover, it has an increasing incidence in the population (15). Non-alcoholic fatty liver disease is positively correlated with the insulin resistance, obesity, hypertension and dislipidemia. The evaluation of hepatosteatosis should include the other metabolic diseases of the liver. The leading cause of death in the world is cardiovascular diseases; and there are many risk factors for cardiovascular diseases including diabetes mellitus, dislipidemia, hypertension and as well as early onset of cardiovascular disease in family history.It is shown that the rate of mortality in cardiovascular diseases is related with microalbuminuria. Microalbuminuria is an early indicator of glomerular injury, and it is an important risk factor for cardiovascular diseases and nephropathy (1-6). Many previous studies performed for searching the coincidence of non-alcoholic fatty liver disease with microalbuminuria in diabetic patients. The present study aimed to assess the relation of hepatosteatosis with renal functions and hypertension in nondiabetic patients.Subjects were recruited from the Department of Internal Medicine and Gastroenterology of Gazi University in a period between November 2009 and November 2010. 49 patients were selected, who were diagnosed non-alcoholic fatty liver disease with ultrasound imaging and own our study criterion. On the other hand, 40 healthy-by means of who hasnt got non-alcoholic fatty liver disease persons added to our study as control group. In the case group, 20 patients had grade 1 (40.8%), 26 patients had grade 2 (53.1%) and only 3 patients had grade 3 (6.1%) non-alcoholic fatty liver disease. Because of the diabetes mellitus was one of our exclusion criteria, there were only few grade 3 patients.In the case group; mean systolic and diastolic pressure for 24 hours; mean daily systolic pressure and mean systolic and diastolic pressure for night were higher than control group and the difference was statistically significant (p<0.001). There was also a significant difference between two groups for the grade of systolic and diastolic dipping. Diabetes Mellitus was an exclusion criterion and so the fasting serum glucose level was not different in both group (p=0.658). Serum trigliserid level was markedly increased in case group (p=0.001). Serum HDL levels were lower in the group with non-alcoholic fatty liver disease and the difference was statistically significant (p<0.001). Related to the differences on the lipid profiles, the case group had higher frequencies of metabolic syndrome and its components: body mass index, waist circumference and body weight. Microalbuminuria, one of an indicator of vascular injury and a risk factor of cardiovascular disease, was higher in case group when compared to general population.In conclusion; although the effect of non-alcoholic fatty liver disease on the blood pressure and non dipper blood pressure profile is not clear, both hypertension and non dipper hypertension profile is more frequent in individuals with non-alcoholic fatty liver disease. There was a negative correlation between non-alcoholic fatty liver disease and systolic blood pressure, diastolic blood pressure dipping as well as HDL, and positive correlation between non-alcoholic fatty liver disease and blood pressure, serum trigliserid levels, body weight, body mass index, waist circumference,metabolic syndrome and microalbuminuria. We advice that the patients must be evaluated for cardiovascular and hypertension with caution.