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非药物治疗人群中脂肪肝指数与左心室舒张功能障碍的独立相关性。

Independent Association of Fatty Liver Index With Left Ventricular Diastolic Dysfunction in Subjects Without Medication.

机构信息

Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.

Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.

出版信息

Am J Cardiol. 2021 Nov 1;158:139-146. doi: 10.1016/j.amjcard.2021.07.047. Epub 2021 Aug 31.

Abstract

Nonalcoholic fatty liver disease has been reported to be potentially linked to cardiovascular disease. Fatty liver index (FLI) is a noninvasive and simple predictor of nonalcoholic fatty liver disease. However, little is known about the relationship between FLI and cardiac function, especially in a general population. We investigated the relationships of FLI with echocardiographic parameters in 185 subjects (men/women: 79/106) of the Tanno-Sobetsu Study, a population-based cohort, who were not being treated with any medication and who underwent echocardiography. FLI was negatively correlated with high-density lipoprotein cholesterol and peak myocardial velocity during early diastole (e'; r = -0.342, p <0.001), an index of left ventricular (LV) diastolic function, and ratio of peak mitral velocities during early and late diastole (E/A) and was positively correlated with age, systolic and diastolic blood pressures, creatinine, uric acid, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein, ratio of mitral to myocardial early diastolic peak velocity (E/e'), left atrial volume index and LV mass index. No significant correlation was found between FLI and LV ejection fraction. Stepwise multivariable regression analysis showed that FLI was independently and negatively associated with e' after adjustment of age, gender, high-density lipoprotein cholesterol, homeostasis model assessment of insulin resistance, and high-sensitivity C-reactive protein. Conversely, e' was independently and negatively associated with FLI after adjustment of age, gender, systolic blood pressure, and LV ejection fraction. In conclusion, elevated FLI is independently associated with LV diastolic dysfunction in a general population without medication. FLI would be a novel marker of LV diastolic dysfunction as an early sign of myocardial injury.

摘要

非酒精性脂肪性肝病与心血管疾病有潜在关联。脂肪性肝病指数(FLI)是一种非侵入性且简单的非酒精性脂肪性肝病预测指标。然而,关于 FLI 与心脏功能之间的关系,尤其是在一般人群中,人们知之甚少。我们在 Tanno-Sobetsu 研究中,调查了 185 名(男/女:79/106)未接受任何药物治疗且接受超声心动图检查的受试者的 FLI 与超声心动图参数之间的关系。FLI 与高密度脂蛋白胆固醇和舒张早期峰值心肌速度(e';r=-0.342,p<0.001)呈负相关,这是左心室(LV)舒张功能的指标,与舒张早期和晚期峰值二尖瓣速度比(E/A)呈正相关,与年龄、收缩压和舒张压、肌酐、尿酸、胰岛素抵抗的稳态模型评估、高敏 C 反应蛋白、二尖瓣与心肌舒张早期峰值速度比(E/e')、左心房容积指数和 LV 质量指数呈正相关。FLI 与 LV 射血分数之间无显著相关性。逐步多元回归分析显示,在调整年龄、性别、高密度脂蛋白胆固醇、胰岛素抵抗的稳态模型评估和高敏 C 反应蛋白后,FLI 与 e' 独立负相关。相反,在调整年龄、性别、收缩压和 LV 射血分数后,e' 与 FLI 独立负相关。总之,在未服用药物的一般人群中,升高的 FLI 与 LV 舒张功能障碍独立相关。FLI 可能是心肌损伤早期的 LV 舒张功能障碍的新标志物。

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