Structural and Functional Peculiarities of Cardiac Changes in Non-Alcoholic Fatty Liver Disease Patients With Different Polymorphic Variants of the Deletion Polymorphism of the Glutathione-S-Transferase M1 Gene

Abstract

Introduction. Epidemiological studies indicate a higher incidence of adverse cardiovascular events in patients with non-alcoholic fatty liver disease (NAFLD) as compared to the general population. In the case of a comorbid combination of liver and cardiovascular diseases, the natural course of cardiovascular pathology may be different even in patients with similar liver changes, indicating that this differences may be genetically determined. The aim of this study. To find out structural and functional peculiarities of cardiac changes in non-alcoholic fatty liver patients disease with different polymorphic variants of the deletion polymorphism of the glutathione-S-transferase M1 gene. Materials and methods. The study included 104 NAFLD patients and 45 healthy individuals (control group). First group included 52 patients without deletion of the GSTM1 gene, second group consisted of 52 patients with deletion of the GSTM1 gene. All patients and practically healthy people were performed with objective examination, determination of anthropometric parameters, general and biochemical blood tests, ultrasonographic examination of abdominal organs, elastography of the liver, echocardiographic investigation, investigation of the GSTM1 gene deletion polymorphism. Results. The distribution of polymorphic variants of the deletion polymorphism GSTM1 among NAFLD patients did not differ from healthy individuals. In patients with deletion variant of the GSTM1 gene, a larger diameter of the left atrium was noted by 0.34 cm (8.3 %, p = 0.007), end diastolic size of the left ventricle by 0.42 cm (7.9 %, p = 0.02) and end systolic size by 0.44 cm (12.5 %, p = 0.02) end diastolic volume by 23.2 % (p = 0.03) end systolic volume by 34.5 % (p = 0.04) left ventricular myocardial mass by 16.4 % (p = 0.03) as compared to the corresponding values in patients without deletion of the GSTM1 gene. For female patients with GSTM1 (-) a greater left ventricular myocardial mass index by 24.6 % (p = 0.02) was characteristic in comparison with female patients with GSTM (+). Eccentric hypertrophy was detected in 24.0 % of patients of the first group and 44.0 % of patients of the second group as a result of calculating the type of geometric configuration of the left ventricle myocardium. Concentric hypertrophy was diagnosed in 76.0 % and 52.0 % of patients, respectively, and concentric remodeling of left ventricle was detected in 4.0 % of patients in the second group. The likelihood of type of myocardial hypertrophy depending on the polymorphic variant of the GSTM1 gene was not significantly different, we note only a tendency to increase the number of patients with concentric hypertrophy in the first group and those with eccentric hypertrophy in the second group. Conclusions. Conducted studies have shown that non-alcoholic fatty liver disease patients with different polymorphic variants of the deletion polymorphism of the glutathione-S-transferase M1 gene are characterized by different structural and functional changes of the heart. The distribution of polymorphic variants of the glutathione-S-transferase M1 gene is not significantly different in patients with non-alcoholic fatty liver disease and healthy individuals. Deletion genotype of the glutathione-S-transferase M1 gene in non-alcoholic fatty liver disease patients is associated with larger diameter of the left atrium, end systolic and diastolic sizes and volumes of the left ventricle, left ventricular myocardium mass, and in female patients also left ventricle myocardium mass index as compared to the corresponding indicators in patients without deletion of the gene functional allele.

Keywords

• echocardiography
• glutathione-s-transferase m1 gene
• non-alcoholic fatty liver disease