非酒精性脂肪性肝病，非特异性ST-T段改变的潜在危险因素：一项横断面研究的数据
Nonalcoholic fatty liver disease, a potential risk factor of non-specific ST-T segment changes: data from a cross-sectional study.
作者信息
Xiao Li, Bai Tao, Zeng Junchao, Yang Rui, Yang Ling
机构信息
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Physical Examination (Health Management) Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
PeerJ. 2020 May 13;8:e9090. doi: 10.7717/peerj.9090. eCollection 2020.
BACKGROUND
Non-specific ST-T segment changes are prevalent and are proven risk factors for early onset of cardiovascular diseases. They can increase all-cause mortality by 100∼200% and are candidate for early signs of cardiovascular changes. Nonalcoholic fatty liver disease (NAFLD) is prevalent worldwide and is one facet of a multisystem disease that confers substantial increases morbidity and mortality of nonalcoholic fatty liver-related cardiovascular diseases. It is unclear whether NAFLD is associated with non-specific ST-T changes warning early signs of cardiovascular changes. Therefore, we investigated this association.
METHODS
A cross-sectional study was designed that included a sample consisting of 32,922 participants who underwent health examinations. Participants with missing information, excessive alcohol intake, viral hepatitis, chronic liver disease or established cardiovascular diseases were excluded. Electrocardiograms were used for analysis of non-specific ST-T segment changes. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis without other liver diseases. A multivariable logistic regression model was served to calculate the OR and 95% CI for non-specific ST-T segment changes.
RESULTS
The prevalence of non-specific ST-T segment changes was 6.5% in participants with NAFLD, however, the prevalence of NAFLD was 42.9% in participants with non-specific ST-T segment changes. NAFLD was independently associated with non-specific ST-T segment changes (OR: 1.925, 95% CI: 1.727-2.143, < 0.001). After adjusting for age, sex, heart rate, hypertension, body mass index, fasting glucose, total cholesterol, triglycerides, HDL-C, NAFLD remained an independent risk factor of non-specific ST-T segment changes (OR: 1.289, 95% CI: 1.122-1.480).
CONCLUSION
Non-specific ST-T segment changes were independently associated with the presence of NAFLD after adjusting for potential confounders.
背景
非特异性ST-T段改变很常见，并且是心血管疾病早期发作的已证实的危险因素。它们可使全因死亡率增加100%至200%，是心血管变化早期迹象的候选指标。非酒精性脂肪性肝病（NAFLD）在全球范围内普遍存在，是一种多系统疾病的一个方面，它会大幅增加非酒精性脂肪性肝病相关心血管疾病的发病率和死亡率。目前尚不清楚NAFLD是否与非特异性ST-T改变相关，后者是心血管变化的早期迹象。因此，我们对这种关联进行了调查。
方法
设计了一项横断面研究，样本包括32922名接受健康检查的参与者。排除有信息缺失、过量饮酒、病毒性肝炎、慢性肝病或已确诊心血管疾病的参与者。使用心电图分析非特异性ST-T段改变。通过超声检测肝脂肪变性且无其他肝脏疾病来诊断NAFLD。采用多变量逻辑回归模型计算非特异性ST-T段改变的比值比（OR）和95%置信区间（CI）。
结果
NAFLD参与者中非特异性ST-T段改变的患病率为6.5%，然而，非特异性ST-T段改变参与者中NAFLD的患病率为42.9%。NAFLD与非特异性ST-T段改变独立相关（OR：1.925，95%CI：1.727-2.143，P<0.001）。在调整年龄、性别、心率、高血压、体重指数、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇后，NAFLD仍然是非特异性ST-T段改变的独立危险因素（OR：1.289，95%CI：1.122-1.480）。
结论
在调整潜在混杂因素后，非特异性ST-T段改变与NAFLD的存在独立相关。
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