Higher cardiovascular risk scores and liver fibrosis risk estimated by biomarkers in patients with metabolic-dysfunction-associated fatty liver disease

BACKGROUND

The definition of metabolic-dysfunction-associated fatty liver disease (MAFLD) allows identification of metabolically complicated patients. Fibrosis risk scores are related to cardiovascular risk (CVR) scores and could be useful for the identification of patients at risk of systemic complications.

AIM

To evaluate the relationship between MAFLD and CVR using the Framingham risk score in a group of Mexican patients.

METHODS

Cross-sectional, observational and descriptive study carried out in a cohort of 585 volunteers in the state of Veracruz with MAFLD criteria. The risk of liver fibrosis was calculated with aspartate aminotransferase-to-platelet ratio index, nonalcoholic fatty liver disease score and fibrosis-4, as well as with transient hepatic elastography with Fibroscan^®. The CVR was determined by the Framingham system.

RESULTS

One hundred and twenty-five participants (21.4%) with MAFLD criteria were evaluated, average age 54.4 years, 63.2% were women, body mass index 32.3 kg/m². The Framingham CVR was high in 43 patients (33.9%). Transient elastography was performed in 55.2% of volunteers; 39.1% with high CVR and predominance in advanced fibrosis (F3–F4). The logistic regression analysis showed that liver fibrosis, diabetes and hypertension independently increased CVR.

CONCLUSION

One of every three patients with MAFLD had a high CVR, and in those with high fibrosis risk, the CVR risk was even greater.

Effects of repeated zimelidine administration on sleep parameters in the rat

Seven-hour sleep EEG recordings were obtained from rats (N = 15) given a single acute dose, and rats (N = 15) given 14 daily doses of zimelidine, 20 mg/kg IP. REM latency, REM sleep, number of REM episodes, and total sleep time were significantly affected by zimelidine administration when compared to controls, as well as to each animal's baseline sleep parameters. Sleep latency and slow-wave sleep were not significantly affected by zimelidine. The results are discussed in terms of the implications of the use of zimelidine as a clinical treatment for depression, as well as the implications for the use of REM changes as a diagnostic indicator of the efficacy of treatment with zimelidine.

Effects of acute doses of zimelidine on REM sleep in rats

Sleep EEG (7 h) were obtained from 11 rats given 5, 10, and 20 mg/kg zimelidine, and a control dose of saline. Zimelidine significantly suppressed REM sleep, lengthened REM latency, and reduced total sleep time (TST) in a dose-dependent manner. Sleep latency was not affected except at the highest dose of zimelidine. Slow-wave sleep (SWS) was not affected at any dose. The results are discussed in terms of their implication for the use of zimelidine in the clinical treatment of depression.

Imipramine and REM sleep: cholinergic mediation in animals

To date it has not been established whether the anticholinergic properties of imipramine are responsible for the drug's suppresion of REM and prolongation of REM induction. A cholinesterase inhibitor, physostigmine, was administered in conjunction with imipramine to determine if these effects of imipramine were cholinergically medicated. Sleep EEG recordings were observed in rats administered either physostigmine (1.0 mg/kg), or imipramine (1.25, 2.5 or 5.0 mg/kg), alone or in combination. The results indicate that physostigmine blocks the effects of imipramine on REM latency.

Effects of L-tryptophan and ethanol on sleep parameters in the rat

Sleep parameters were monitored following (1) a single 2 g/kg oral dose of ethanol, (2) an oral dose of L-tryptophan (600 mg/kg), and (3) administration of both drugs simultaneously. Ethanol reduced REM and increased slow wave significantly. The effects of L-tryptophan were apparent only in the case of one parameter, REM latency. Administration of both drugs resulted in a significantly shorter REM latency than that observed for ethanol alone. Results are discussed in terms of possible changes in the biosynthesis of 5-HT.

Effects of chronic and acute ethanol administration on sleep in laboratory rats

Long- and short-term administration of nonintoxicating doses of ethanol affected sleep parameters in rats.