Background: Arterial function is a marker of early atherosclerotic changes and cardiovascular disease. Several studies have suggested the possible association between nonalcoholic fatty liver disease (NAFLD) and increased arterial stiffness. Thus, we conducted a systematic review and meta-analysis to better characterize this association.
Patients and methods: A comprehensive search of the databases of the MEDLINE and EMBASE was carried out from inception through September 2016. All observational studies that compared arterial stiffness between NAFLD patients and healthy controls were included. Arterial stiffness was measured by pulse wave velocity (PWV) and augmentation index. We calculated pooled mean difference (MD) with 95% confidence intervals (CIs) using the random-effects model.
Results: Data were extracted from 12 studies involving 9351 NAFLD patients and 17 684 controls. NAFLD is significantly associated with increased arterial stiffness as determined by carotid–femoral PWV (MD=0.75 m/s, 95% CI: 0.43–1.07, I2=88%), brachial–ankle PWV (MD=0.82 m/s, 95% CI: 0.57–1.07, I2=92%), and augmentation index (pooled MD=2.54%, 95% CI: 0.07–5.01, I2=73%) compared with healthy controls.
Conclusion: In conclusion, our study demonstrated a higher degree of arterial stiffness in NAFLD patients compared with controls. However, this association might be related to the higher prevalence of cardiometabolic risk factors in NAFLD patients. Further studies are needed to determine an independent association between NAFLD and arterial stiffness adjusting to cardiometabolic risks.
aDepartment of Internal Medicine, University of Hawaii, Honolulu, Hawaii
bDepartment of Internal Medicine, Metrowest Medical Center, Framingham, Massachusetts
cDepartment of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York, USA
dDepartment of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
eDepartment of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Correspondence to Anawin Sanguankeo, MD, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand Tel: +66 808 542 1939; fax: +66 607 547 6612; e-mail: firstname.lastname@example.org
Received February 8, 2017
Accepted April 26, 2017