Abstract. The effect of hypertension on non-alcoholic fatty liver disease (NAFLD) remains unclear at the molecular level. In this study, we investigated the effects of hypertension on the degree of hepatic steatosis, liver injury and hepatic fibrosis induced by a choline-deficient L-amino acid-defined (CDAA) diet in spontaneously hypertensive rats (SHRs). Seven-week-old male SHRs were fed standard chow with high or normal salt concentrations for 7 weeks, followed by a CDAA diet containing high or normal salt for an additional 8 or 24 weeks. Hepatic steatosis was assessed using hepatic triglyceride levels and Oil red O staining. Hepatic fibrosis was evaluated using Sirius red and Azan staining. Systolic blood pressure (SBP) gradually increased with a high-salt diet and was significantly higher after 7 weeks of feeding with highsalt vs. normal-salt chow. After 8 weeks on the CDAA diet, the degree of hepatic steatosis did not differ between the high-salt and normal-salt groups; however, alanine aminotransferase and fasting blood glucose levels were significantly higher and hepatic mRNA levels for interleukin (IL)-10 and heme oxygenase (HO)-1 were significantly lower in the high-salt group compared with the normal-salt group. After 24 weeks on the CDAA diet, the high-salt group had significantly more severe hepatic fibrosis and a higher hepatic mRNA expression of α-smooth muscle actin and lower hepatic IL-10 and HO-1 mRNA levels compared with the normal-salt group. In conclusion, our results indicate that hypertension is a potential risk factor for liver injury and hepatic fibrosis through glucose intolerance and decreased IL-10-mediated or HO-1-induced anti-inflammatory mechanisms.
IntroductionNon-alcoholic fatty liver disease (NAFLD) includes nonalcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), and NASH may lead to hepatic cirrhosis or hepatocellular carcinoma (HCC) (1,2). NAFLD/NASH can be viewed as a metabolic syndrome phenotype involving the liver, and the incidence of NAFLD has increased with corresponding increases in risk factors for metabolic syndrome, such as obesity, diabetes and hypertension. Such metabolic risk factors may promote the pathological progression of NAFLD/NASH, and NAFLD advances more rapidly in patients with a greater number of metabolic risk factors (3,4).The incidence of hypertension is significantly higher in patients with NAFLD compared with the general population (5). Furthermore, a higher incidence of NASH has been observed in patients with NAFLD who also have hypertension and these patients are likely to progress to advanced hepatic fibrosis (6), which suggests that hypertension may promote the onset or progression of hepatitis and hepatic fibrosis. However, the possible association between hypertension and the pathological progression of NAFLD has not been fully established.Rats fed a choline-deficient L-amino acid-defined (CDAA) diet initially develop fatty liver and hepatitis, and may subsequently progress to hepatic fibrosis and HCC (7). These findings indic...