The relationship between nonalcoholic fatty liver disease and atherogenic parameters

ABSTRACT The Relationship Between Nonalcoholic Fatty Liver Disease And Atherogenic Parameters Nonalcoholic Fatty Liver Disease (NAFLD) is a disease which starts with fat accumulation in hepatocytes without excess alcohol consumption, it is associated with obesity, type 2 diabetes, hyperlipidemia and insulin resistance and one of the common causes of chronic liver disease today. NAFLD's incidence varies by geographical region, is between 5-30% and has increased rapidly in the last few decades. NAFLD results in a wide spectrum of diseases ranging from simple fatty liver to severe hepatocellular carcinoma and is accepted as the hepatic manifestation of metabolic syndrome. Visceral Adiposity Index (VAI) is a new, sex-specific index and it is sensitive to simple antropometric and functional parameters. VAI is an indicator for fat distribution and function. Waist circumference (WC), body mass index (BMI), triglyceride (TG), high-density lipoprotein (HDL) and some other coefficients are used in VAI calculation. The relationship between NAFLD and hyperlipidemia has been proven by studies. Atherogenic Index of Plasma (AIP) is defined as a strong indicator for NAFLD. Increase in AIP is correlated with increased BMI, WC and high levels of ALT, GGT and lipid profile. Also, AIP is shown as a potent marker for atherosclerosis and coronary heart diseases. Today, it is found that the most common cause of death in NAFLD patients is cardiovascular diseases. According to the data, NAFLD, obesity and type 2 diabetes are well known risk factors for cardiovascular diseases and closely associated with atherosclerosis development. NAFLD is a predictor for the risk of cardiovascular disease. It also increases the risk of cardiovascular morbidity and mortality, as well as cancer and liver related death. The number of patients who requires liver transplantation because of NAFLD is increasing gradually in the whole world. NAFLD is the second most common cause of liver transplantation in USA and Europe. Even though NAFLD is more common in patients who has obesity and insulin resistance, it's incidence is increasing progressively in patients who is not obese and does not have insulin resistance. In this study, we aimed to determine the relationship between NAFLD and atherogenic parameters. Our study was conducted with the participants who visited Erzincan Binali Yıldırım Üniversitesi Mengücek Gazi Eğitim ve Araştırma Hastanesi Internal Medicine outpatient clinic for routine control, are in between 18-65 ages and doesn't have thyroid disfunction, doesn't use any antihyperlipidemic drug, doesn't consume over than 40 grams alcohol per week, are serologically negative for any viral or autoimmune hepatitis, doesn't have any hereditary condition like Wilson's Disease or Hemochromatosis, hasn't taken any parenteral nutrition treatment recently, hasn't been underwent any bariatric procedure, jejuno-ileal bypass procedure or small bowel resection and additionally doesn't have any history of drug usage which is known to cause steatosis. We made comparisons in between two groups with and without fatty liver. The participants of the study are compared for age, gender, VAI, AIP, NAFLD Fibrosis Score, BMI, WC, systolic and diastolic blood pressure, smoking duration and certain laboratory parameters. As a result of these comparisons, a statistically significant difference was found between the WC, BMI, systolic and diastolic blood pressure, VAI, AIP of the two groups with and without steatosis. When we made a comparison between laboratory parameters of these two groups, there were a statistically significant difference for TG, HDL cholesterol, ALT, AST, GGT, uric acid, ferritin and NAFLD Fibrosis score. We performed a correlation test to determine the parameters related to the degree of fatty liver and as a result of the test we have found that there was a moderate positive relationship between ALT and the degree of fatty liver. In addition to that, it is found that there was a weak positive correlation between WC, VAI, AIP, TG, AST, GGT and the degree of fatty liver. A regression analysis is performed and we found that AIP is the most significant indicator for fatty liver. Additionally, BMI and ferritin are also among the determinants of fatty liver risk. The significant statistical relationship between NAFLD and atherogenic parameters that is found as a result of our study suggests that these parameters can be used to predict NAFLD. Thus, it is considered that timely initiation of lifestyle changes and medical treatments to reduce fatty liver in patients who have an increased risk of developing cardiovascular disease, cirrhosis and hepatocellular carcinoma will be beneficial. Keywords: Nonalcoholic Fatty Liver Disease (NAFLD), visceral adiposity index (VAI), atherogenic index of plasma (AIP)