Comparative Study of Autonomic Functions by Reactivity Tests and Biochemical Parameters in Alcoholic and Nonalcoholic Fatty Liver Disease Patients
Divyashree N. Uchil, Ahrsia V. Fathima, Kalpana Balasubramaniyam, Shobith BangeraAbstract
Background:
Long-term consumption of alcohol is associated with metabolic syndrome, central obesity, and cardiovascular disease. Nonalcoholic fatty liver disease (NAFLD) not only affects the liver but also alters the functions of the cardiovascular system. These changes are responsible for increased cardiac morbidity and mortality. Diabetes, uncontrolled high blood pressure (BP), long-term heavy drinking, and autoimmune disorders cause damage or injury to the nerves and result in autonomic dysfunction.
Materials and Methods:
This comparative and cross-sectional study included 78 alcoholic fatty liver disease (AFLD) and 54 NAFLD patients. Autonomic function was assessed using cardiovascular reactivity tests, including heart rate response to standing (30:15 ratio), heart rate response to deep breathing (E:I ratio), BP response to standing, and BP response to sustained handgrip test. Liver function tests were recorded from their clinical laboratory reports.
Results:
Heart rate response to standing was significantly higher in the AFLD group as compared to the NAFLD group. Heart rate response to deep breathing was significantly higher in the NAFLD group as compared to the AFLD group. Among the biochemical parameters, ALT levels showed statistically significant difference between the groups, and total bilirubin was significantly higher in the AFLD group as compared to NAFLD.
Conclusion:
Autonomic functions were altered in both alcoholic and NAFLD patients. Parasympathetic activity was relatively reduced in AFLD compared to NAFLD. These findings suggest alcohol induced and metabolic related liver injury influences cardiovascular autonomic function. Lifestyle modification and alcohol withdrawal may help prevent disease progression and associated cardiovascular risk.