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非酒精性脂肪性肝病的非糖尿病男性患者异位脂肪沉积与左心室功能。

Ectopic fat depots and left ventricular function in nondiabetic men with nonalcoholic fatty liver disease.

机构信息

From the Diabetes and Obesity Research Program, Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital (M.G., M.O.P., M.S.N., M.-R.T.), Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital (K.N., J.L., A.H., K.L., N.L.), and Department of General Practice and Primary Health Care, Health Center of City of Helsinki (R.S.), University of Helsinki, Helsinki, Finland.

出版信息

Circ Cardiovasc Imaging. 2014 Dec 30;8(1). doi: 10.1161/CIRCIMAGING.114.001979. Print 2015 Jan.

Abstract

BACKGROUND

Nonalcoholic fatty liver disease has emerged as a novel cardiovascular risk factor. The aim of the study was to assess the effect of different ectopic fat depots on left ventricular (LV) function in subjects with nonalcoholic fatty liver disease.

METHODS AND RESULTS

Myocardial and hepatic triglyceride contents were measured with 1.5 T magnetic resonance spectroscopy and LV function, visceral adipose tissue (VAT) and subcutaneous adipose tissue, epicardial and pericardial fat by MRI in 75 nondiabetic men. Subjects were stratified by hepatic triglyceride content into low, moderate, and high liver fat groups. Myocardial triglyceride, epicardial and pericardial fat, VAT, and subcutaneous adipose tissue increased stepwise from low to high liver fat group. Parameters of LV diastolic function showed a stepwise decrease over tertiles of liver fat and VAT, and they were inversely correlated with hepatic triglyceride, VAT, and VAT/subcutaneous adipose tissue ratio. In multivariable analyses, hepatic triglyceride and VAT were independent predictors of LV diastolic function, whereas myocardial triglyceride was not associated with measures of diastolic function.

CONCLUSIONS

Myocardial triglyceride, epicardial and pericardial fat increased with increasing amount of liver fat and VAT. Hepatic steatosis and VAT associated with significant changes in LV structure and function. The association of LV diastolic function with hepatic triglyceride and VAT may be because of toxic systemic effects. The effects of myocardial triglyceride on LV structure and function seem to be more complex than previously thought and merit further study.

摘要

背景

非酒精性脂肪肝已成为一种新的心血管危险因素。本研究旨在评估不同异位脂肪沉积对非酒精性脂肪肝患者左心室(LV)功能的影响。

方法和结果

本研究使用 1.5T 磁共振波谱仪测量了 75 名非糖尿病男性的心肌和肝组织甘油三酯含量,使用 MRI 测量了 LV 功能、内脏脂肪组织(VAT)和皮下脂肪组织、心外膜和心包脂肪。根据肝组织甘油三酯含量将受试者分为低、中、高肝脂组。心肌甘油三酯、心外膜和心包脂肪、VAT 和皮下脂肪组织从低肝脂组到高肝脂组呈逐步增加。LV 舒张功能参数随肝脂和 VAT 的三分位逐渐降低,与肝组织甘油三酯、VAT 和 VAT/皮下脂肪组织比值呈负相关。多变量分析显示,肝组织甘油三酯和 VAT 是 LV 舒张功能的独立预测因子,而心肌甘油三酯与舒张功能指标无关。

结论

心肌甘油三酯、心外膜和心包脂肪随肝脂肪和 VAT 的增加而增加。肝脂肪变性和 VAT 与 LV 结构和功能的显著变化相关。LV 舒张功能与肝组织甘油三酯和 VAT 的相关性可能是由于全身毒性作用。心肌甘油三酯对 LV 结构和功能的影响似乎比以前认为的更为复杂,值得进一步研究。

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