Arteriosclerosis and Vascular Endothelial Function in Chronic Liver Disease

Background: Patients with chronic liver disease (CLD) are known to have a low incidence of cardiovascular events. However, the extent of arteriosclerosis in CLD has not been studied well. Aims: To assess arteriosclerosis in CLD, and to assess and examine vascular endothelial function. Methods: The subjects were 17 patients with chronic hepatitis (CH), 48 patients with liver cirrhosis (LC), and 18 non-CLD patients (control) with no history of cardiovascular events (coronary artery disease: CAD). Arteriosclerosis was assessed by ultrasonic determination of intima-media complex thickness (IMT) and stiffness parameter (β value) of the common carotid artery. Vascular endothelial function was assessed by determining flow-mediated dilatation (FMD) of the brachial artery. Nitrogen oxides (NOx), angiotensin II (AG II), and endothelin-1 (ET-1) were measured as vasoactive substances in the serum of all subjects. The concentration of adiponectin, which has antiatherogenic action, was also measured in the serum of all subjects. Results: No significant differences in IMT or β value were found between the groups. The FMD in CH (5.8 ∓ 1.9%) was significantly higher compared to the control (3.4 ∓ 1.4%) (F=3.3, p=0.015). The serum concentrations of ET-1 and adiponectin in CLD patients were greater the more advanced the disease. Conclusions: There were no apparent differences in the extent of arteriosclerosis between CLD and the control, while vascular endothelial function in CLD was better preserved compared to the control, which may be attributable to the antioxidant action of nitric oxide (NO) and/or the antiatherogenic action of adiponectin.