Department of Radiology, University of California at San Diego, 200 W. Arbor Drive #8756, La Jolla, San Diego, CA, 92103, USA.
NAFLD Research Center and Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
Eur Radiol. 2018 Apr;28(4):1345-1355. doi: 10.1007/s00330-017-5075-6. Epub 2017 Oct 20.
To determine whether severity of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis quantitatively assessed in individuals with diabetes mellitus (DM)-2 correlate with increased coronary heart disease (CHD) risk using non-invasive markers.
We conducted a single-centre, prospective, cross-sectional study in 100 consecutive diabetic individuals without known CHD recruited between March 2013 and September 2014. History, physical examination, serum markers, cardiac computed tomography (CT), magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) and MR elastography (MRE) were obtained for 95 participants. Written informed consent was provided. Institutional review board approved this study. Spearman rank correlation was performed to assess for correlations. Multiple linear regression model determined independent predictors of epicardial adipose tissue (EAT) volume.
A p value < 0.05 determined statistical significance. The EAT volume was higher in the NAFLD group, defined as MR-imaging PDFF ≥ 5 %, compared to the non-NAFLD group (126.5 ml (IQR 80.9) versus 85.4 ml (IQR 44.7), p=0.002). MR imaging-PDFF correlated with EAT (r=0.42, p < 0.0001). MR imaging-PDFF and liver fibrosis were independently associated with EAT.
Higher liver fat content and liver fibrosis may portend worse cardiovascular risk in diabetics.
• EAT volume is higher in diabetic individuals with NAFLD. • Liver fat content is positively correlated with EAT. • Liver fat content and liver fibrosis were independently associated with EAT. • Higher liver fat content and fibrosis may adversely affect cardiovascular risk.
使用非侵入性标志物，确定 2 型糖尿病患者中非酒精性脂肪性肝病（NAFLD）和肝纤维化的严重程度与冠心病（CHD）风险增加之间是否存在定量相关性。
我们于 2013 年 3 月至 2014 年 9 月在一家中心进行了一项单中心、前瞻性、横断面研究，共纳入 100 例连续的、无已知 CHD 的糖尿病患者。对 95 例患者进行了病史、体格检查、血清标志物、心脏计算机断层扫描（CT）、磁共振（MR）成像估计质子密度脂肪分数（PDFF）和 MR 弹性成像（MRE）检查。所有患者均签署了书面知情同意书，本研究经机构审查委员会批准。采用 Spearman 秩相关分析评估相关性。多元线性回归模型确定心外膜脂肪组织（EAT）体积的独立预测因子。
P 值＜0.05 为统计学显著差异。与非 NAFLD 组相比，MR 成像 PDFF≥5%的 NAFLD 组的 EAT 体积更高（126.5ml（IQR 80.9）比 85.4ml（IQR 44.7），p=0.002）。MR 成像-PDFF 与 EAT 呈正相关（r=0.42，p＜0.0001）。MR 成像-PDFF 和肝纤维化与 EAT 独立相关。
肝脂肪含量增加和肝纤维化可能预示着糖尿病患者的心血管风险更高。
① 有 NAFLD 的糖尿病患者的 EAT 体积更高。② 肝脂肪含量与 EAT 呈正相关。③ 肝脂肪含量和肝纤维化与 EAT 独立相关。④ 肝脂肪含量和纤维化增加可能对心血管风险产生不利影响。
