NAFLD linked to cardiac autonomic nervous system dysfunction

Patients with nonalcoholic fatty liver disease (NAFLD) are likely to have cardiac sympathetic/parasympathetic imbalance, regardless of the presence of type 2 diabetes mellitus (T2DM) and other potential confounding factors, a study has found.

Cardiovascular disease (CVD) is the leading cause of death in NAFLD patients with or without T2DM, whereas cardiac autonomic dysfunction is a risk factor for CVD morbidity and mortality. The present study used data from the Cooperative Health Research in South Tyrol (CHRIS) study and included 173 patients with T2DM and 183 age- and sex-matched nondiabetic controls to examine the potential association between NAFLD and impaired cardiac autonomic function.

All participants underwent ultrasonography and vibration-controlled transient elastography to determine the presence of hepatic steatosis and liver stiffness. Researchers calculated the low-frequency to high-frequency (LF/HF) power ratio and other heart rate variability measures from a 20-min resting electrocardiogram in order to derive a measure of cardiac sympathetic/parasympathetic imbalance.

In the entire population, 117 participants had NAFLD and T2DM, 56 had T2DM alone, 68 had NAFLD alone, and 115 had neither condition (control). The likelihood of having cardiac sympathetic/parasympathetic imbalance was high among participants with T2DM and NAFLD (adjusted odds ratio [aOR], 4.29, 95 percent confidence interval [CI], 1.90–10.6) and those with NAFLD alone (aOR, 3.41, 95 percent CI, 1.59–7.29) relative to controls.

The associations remained significant despite adjustment for established CVD risk factors and other potential confounders.