The Relationship And Possible Pathogenesis Between Coronary Heart Disease And Nonalcoholic Fatty Liver Disease

Coronary heart disease (CHD), also known as ischemic heart disease,includes coronary atherosclerotic heart disease and coronary artery functional changes. According to WHO, CHD is one of the most common causes of death in the world. With the aging population and enhancement of living standards, the morbidity and mortality of CHD is growing year by year in China. Despite overwhelming research, the etiopathogenesis of CHD is still not completely understood. CHD has been recognized as a complex, multifactorial disease. Traditional risk factors said to be related to CHD include age, sex, physical inactivity, negative emotions, type A personality, hypertension, diabetes and dyslipidemia. Recent researches have demonstrated that risk factors such as inflammation, respiratory infections, excessive coffee intake, air pollution , hyperuricacidemia, hyperhomocysteinemia are related to CHD. With extensive research on the etiology of CHD, some researchers have suggested that morbidity in patients with coronary artery disease is related to nonalcoholic fatty liver disease(NAFLD) patients and higher than in the average population and patients with alanine aminotransferase (ALT) mild elevated of coronary atherosclerosis degree is increased. Quite recently, there has been substantial research on NAFLD,elevated ALT and CHD but results proved to be inconsistent. This study was conducted to observe the morbidity of CHD in NAFLD patients, and analyse the possible pathogenesis of nonalcoholic fatty liver in patients with CHD.Objective: To determine the relationship between NAFLD and morbidity of CHD, discuss the possible pathogenesis of the blood serum of ALT , NAFLD and CHD.Methods: A total of 105 patients with NAFLD were recruited from Feb. 2009 to Feb. 2011; 55 males and 50 females. The average age was 51.3±10.3. Briefly, 95 healthy volunteers were also recruited within the same period of time, 45 males, 40 females. The average age was 50.4±10.4 years old. The NAFLD group was divided into two groups: A group: ALT>40IU/L; B group: ALT>40IU/L . Observational indexes were serum TC, serum TG, serum LDL-C, serum HDL-C , serum Apo A1,serum Apo B,serum ALT,serum UA,fasting GLU. We used neck B-ultrasound to measure the carotid artery intima-media thickness (IMT).Results:①The levels of the serum TC, serum TG, serum LDL-C, serum Apo B,Apo A1/ Apo B,fasting plasma GLU concentration of A group was higher than B group, but there was no significant difference(P >0.05). The serum TC, serum TG, serum LDL-C, serum HDL-C, fasting plasma GLU concentration of NAFLD group was different from the control group (P<0.05)②. The serum ALT and serum TG offer positive correlation(r=0.166, P<0.05).③. The level of serum UA of A group was higher than B group (P<0.05). The serum UA of NAFLD group was different from the control group (P<0.05)④. The level of carotid intima-media thickness, number of carotid plaques and carotid plaques detection rate of A group are higher than B group (P<0.05). The level of carotid intima-media thickness, number of carotid plaques and carotid plaques detection rate of NAFLD group were higher than the control group (P<0.05).Conclusion: The morbidity of CHD in NAFLD patients was higher than other group of people, those of higher ALT was easily identifiable. The level of ALT was closely related to the development and progress of CHD. The pathogenesis of CHD may be associated with conventional risk factors such as lipid metabolism disturbance, hyperuricemia and hyperglycemia. NAFLD can be used as an independent risk factor to predict atherosclerosis.