Battisti, Giacomo

Bergamasco, Laura Maria

Bugianesi, Elisabetta

Cannillo, Margherita

Faletti, Riccardo

Frea, S.

Marengo, Andrea

Mezzabotta, Lavinia

Morello, Mara

Mosso, E.

Rizzetto, Mario

Rosso, Chiara

Vanni, Ester

English

Institutional Research Information System University of Turin

RS-3519Fatty liver diseaseClinicalINSULIN RESISTANCE AND LIVER DAMAGE ARE ASSOCIATED WITH EARLY SIGNS OF LEFT VENTRICULARSYSTOLIC DYSFUNCTION IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE INDEPENDENT OFDIABETES, HYPERTENSION AND DYSLIPIDEMIA.Ester Vanni1, Lavinia Mezzabotta* 1, Riccardo Faletti2, Mara Morello3, Andrea Marengo1, Giacomo Battisti2, Simone Frea3,Margherita Cannillo3, Elena Mosso1, Chiara Rosso1, Laura Bergamasco4, Mario Rizzetto1, Elisabetta Bugianesi11University of Turin, Department of Medical Sciences, Division of Gastroenterology, 2University of Turin, Department ofDiagnostic Imaging and Radiotherapy, Radiology, 3University of Turin, Department of Medical Sciences, Division ofCardiology, 4University of Turin, Turin, ItalyCorresponding author’s email: estervanni@yahoo.itDo you want to apply for a Young Investigator Bursary?: YesBackground and Aims: Nonalcoholic Fatty Liver Disease (NAFLD) has been associated with subclinical cardiovasculardisease (CVD). This study was undertaken to evaluate the relationship between metabolic parameters, histologicfeatures and parameters of cardiac morphology and function in NAFLD subjects.Methods: Nineteen non-diabetic, non-dyslipidemic, non-hypertensive patients with biopsy-proven NAFLD (17 men, age41±8 years, BMI 26.8±3kg/m2) and 9 healthy controls (5 men, age 30±2 years, BMI 22.5±2kg/m2) underwenttransthoracic echocardiography and cardiac MRI to evaluate cardiac morphology and function. Endogenous glucoseproduction (EGP) and lipolysis were assessed by stable isotope tracers. Hepatic Insulin resistance (IR) as EGP x fastinginsulin, Oral Glucose Insulin Sensitivity (OGIS), adipo-IR as free fatty acids (FFAs) x fasting insulin were calculated.Results: Despite the absence of diabetes, hypertension and overt dyslipidemia, NAFLD patients had significantly higherconcentration of FFAs than controls (p<0.05) and higher total saturated and monounsaturated levels (p<0.05). In NAFLDbasal Hepatic-IR (NAFLD vs controls: 92±34 vs 52±18 umol/min kg*mU/L) and Adipo-IR (NAFLD vs controls: 21±10 vs11±5 mmol/L*mU/L) were significantly increased (p<0.03 for all NAFLD vs controls) and OGIS significantly reduced(NAFLD vs controls: 11.0±1.64 vs 13.1±1.1 mg/kg min, p=0.005). The end-systolic LV diameter (30.4±3.7 vs 27.2±3.5mm, p=0.044) was significantly higher in patients than in controls, suggesting subclinical systolic dysfunction. In NAFLDpatients, both hepatic-IR and adipo-IR directly correlated with MRI end-systolic LV volume (ESV) (r=0.63, p=0.004 andr=0.54, p=0.018, respectively), while OGIS was inversely related to end-systolic LV diameter (r=-0.48, p=0.037) and ESV(r=-0.48, p=0.036). At liver biopsy, steatosis ≥33% was associated with increased ESV (p=0.047), suggesting earlysystolic dysfunction. Similarly, ESV was increased in patients with fibrosis (69.2±16.9 vs 94.5±31.4 cc, p=0.018), whereasthe ejection fraction (51±7 vs 59±7%, p=0.034) and cardiac index (2.9±0.7 vs 3.8±0.9, p=0.03) were significantly reduced.Conclusions: In NAFLD subjects metabolic derangements and histological features are associated with subclinicalsystolic LV dysfunction independent of diabetes, hypertension and dyslipidemia.Funded  by  FP7/2007-2013  under  grant  agreement  n  HEALTH-F2-2009-241762  for  the  project  FLIP  and  by  PRIN2009ARYX4TDisclosure of Interest: None Declared

Insulin resistance and liver damage are associated with early signs of left ventricular systolic dysfunction in patients with Non Alcoholic Fatty Liver Disease independent of diabetes, hypertension and dyslipidemia

https://iris.unito.it/bitstream/2318/1570818/1/Abstract%20EASL%202015%20Vanni.pdf

Insulin resistance and liver damage are associated with early signs of left ventricular systolic dysfunction in patients with Non Alcoholic Fatty Liver Disease independent of diabetes, hypertension and dyslipidemia

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