Elsheikh E, Jeffers T, Younoszai Z, Hunt S, Lam B, Otgonsuren M, Albano MC, Schneider I, Marsiglia B, Raybuck B and Younossi ZM
Background: The levels and function of circulating progenitor cells (CPCs) may be affected by chronic metabolic diseases. Aim: To investigate the levels and functions of CPCs in patients with non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD). Methods: In this retrospective study, patients (n=82) undergoing elective coronary angiography for diagnosis of CAD were included. NAFLD was defined as presence of hepatic steatosis by ultrasound in the absence of other causes of liver disease and excessive alcohol use. After coronary angiography, patients were divided into NAFLD with CAD (n=24), NAFLD without CAD (n=13), only CAD (n=31) and Non-NAFLD and Non-CAD (n=14). CPCs were quantified by flow cytometry based on the expression of (CD34+, CD133+, CD34+CD133+) in presence or absence of the hematopoietic marker (CD45). We assessed serum levels of angiogenic growth factors (AGFs) (pg/ml) by Multiplex assay. Results: The levels of the CD45-CD34+ and CD45-CD133+ were higher in NAFLD patients with CAD (median, 15% and 2%, respectively) than NAFLD patients without CAD (median, 9% and 1%, respectively, all p ≤ 0.05). After age adjustment, only CD45-CD34+ circulating progenitor cells remain associated with increased risk of CAD in patients with NAFLD [OR: 8.71 (1.21-62.51)]. In contrast, the levels of the serum vascular endothelial growth factor-C (VEGF-C) was lower in NAFLD patients with CAD (median, 69 pg/ml) than NAFLD without CAD (median, 146 pg/ml) (p=0.01). Conclusions: Our results indicate that high levels of non-hematopoietic CPCs and low levels of AGFs may be associated with increased risk of CAD in NAFLD patients.
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