Markers of endothelial dysfunction in patients with non‐alcoholic fatty liver disease and coronary artery disease

Abstract

Abstract Background Non‐alcoholic fatty liver disease ( NAFLD ) has been associated with coronary artery disease ( CAD ) and cardiac‐related mortality. Aim To assess the association between endothelial dysfunction markers (Endocan, high mobility group box 1 [ HMGB 1], and anti‐endothelial cell antibodies [ AECAs ]) and the risk of CAD in NAFLD . Methods Ninety‐one patients scheduled for coronary angiography for chest pain were included. Of these, 77 had NAFLD (85% with documented CAD ). NAFLD was diagnosed after exclusion of other causes of liver diseases and by hepatic ultrasound and/or fatty liver index. Diagnosis and severity of CAD were established with coronary angiography. Endocan (ng/ mL ) and HMGB 1 (ng/ mL ) concentrations were determined in the serum using enzyme‐linked immunosorbent assay technique. AECAs were quantified in sera using flow cytometry. Results NAFLD patients with CAD had higher serum endocan level as compared with NAFLD without CAD ( P = 0.006). Furthermore, levels of endocan (odds ratio [ OR ] 38.66 [95% confidence interval { CI } 1.10–999.99]) and hyperlipidemia ( OR 5.62 [95% CI 1.36–23.19]) were significantly associated with the risk of CAD and high serum high‐density lipoprotein cholesterol level ( OR 0.92 [95% CI 0.87–0.97]) was protective against CAD . On the other hand, serum level of HMGB 1 was significantly lower in NAFLD patients with CAD than NAFLD patients without CAD ( P = 0.0003). Interestingly, in our NAFLD cohort, serum endocan levels positively correlated the severity of CAD ( r = 0.27; P < 0.05), whereas HMGB 1 levels negatively correlated with severity of CAD ( r = −0.35; P < 0.05). The levels of AECA were not significantly associated with CAD in NAFLD . Conclusion Markers of endothelial dysfunction in patients NAFLD patients may be associated with the risk for CAD .