The state of vascular endothelium, clinical and metabolic features of patients with coronary heart disease combined with nonalcoholic fatty liver disease

Objective: to study changes in the vascular endothelium state in conjunction with clinical and metabolic features in CHD patients with the concomitant nonalcoholic fatty liver disease.Methods: cross-cohort analytical study involved 86 patients, the primarily selected group consisted of 34 patients, mean age 60 (57.5; 66) with documented coronary artery disease, stable exertional angina of II-III functional class combined with NAFLD; comparison selected group: 32 patients, mean age 60.5 (51.5; 65.6) with coronary artery disease without NAFLD. The control selected group consisted of 20 healthy individuals.Results: In patients with coronary artery disease and NAFLD compared with CHD patients without NAFLD was found significantly higher levels of ADMA by 21 % (p < 0.05), CRP by 1.63 times (p < 0.05), intima-media thickness by 14.28 % (p < 0.05). Using ROC-analysis established that levels of ADMA >0.74 mmol/l is the cutting point and has an optimal ratio of sensitivity (80 %) to the specificity (82.9 %) for the diagnosis of vascular remodeling in CHD patients with concomitant NAFLD. The presence of significant direct correlation relationship of ADMA with CRP, total cholesterol, glucose, body mass index, alkaline phosphatase, ALT and significant negative relation of ADMA with HDL were found.Conclusions: In patients with coronary artery disease, combined with NAFLD structural and functional changes in vascular endothelium (increase in serum levels of ADMA, thickening of intima-media) are observed during activation of systemic inflammation (increased CRP concentration), which is associated with metabolic disorders and liver damage indicators. The value of ADMA in serum prevailing 0.74 mmol/l helps to diagnose structural and functional changes in vascular endothelium in patients with coronary artery disease, comorbid with NAFLD.