Zuo Yifan, Cai Xin, Wang Zhiwei, Hu Zhipeng, Wu Zhiyong, Zhang Min, Yu Anfeng, Liu Liang, Xing Yun
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Front Cardiovasc Med. 2021 Aug 13;8:698285. doi: 10.3389/fcvm.2021.698285. eCollection 2021.
Fatty liver disease (FLD) has emerged as a major public issue in China. We aim to investigate prevalence, clinical features, and in-hospital outcome of FLD in acute aortic dissection (AAD) patients. Data of 379 AAD patients from 2017 to 2019 at Renmin hospital of Wuhan University was retrospectively collected and divided according to age and FLD absence. Propensity score matching was used for minimal confounding. We compared their physical environmental parameter of onset, clinical features, and in-hospital outcome. The mean age was 52.0 ± 11.5 years in type A and 55.1 ± 11.4 in type B. 25.0% of type A and 19.2% of type B AAD patients had FLD. Logistic regression indicated a negative association between FLD and age, both in type A [unadjusted odds ratio (OR) 0.958 (per 1 year), 95% confidence interval (CI) 0.930-0.988, = 0.0064] and type B [unadjusted OR 0.943 (per 1 year), 95% CI 0.910-0.978, = 0.0013]. After matching, type A with FLD had onset with a lower air quality index (AQI) of 68.5 [interquartile range (IQR) 46.0-90.0] and a lower Pm 2.5 concentration of 36.0 μg/m (IQR 23.0-56.0) compared with non-FLD group. In Kaplan-Meier estimation, FLD was associated with higher risk of in-hospital mortality in type B AAD ( = 0.0297). The prevalence of FLD in AAD decrease with age, both in type A and type B AAD. Type A AAD patients with FLD had onset with better air quality parameters compared with non-FLD group. FLD was associated with higher risk of in-hospital mortality in type B AAD.
脂肪性肝病（FLD）已成为中国一个主要的公共卫生问题。我们旨在调查急性主动脉夹层（AAD）患者中FLD的患病率、临床特征及住院结局。回顾性收集了武汉大学人民医院2017年至2019年379例AAD患者的数据，并根据年龄和是否存在FLD进行分组。采用倾向评分匹配以尽量减少混杂因素。我们比较了他们发病时的物理环境参数、临床特征及住院结局。A型患者的平均年龄为52.0±11.5岁，B型为55.1±11.4岁。25.0%的A型和19.2%的B型AAD患者患有FLD。逻辑回归表明，在A型[未调整优势比（OR）0.958（每1岁），95%置信区间（CI）0.930 - 0.988，P = 0.0064]和B型[未调整OR 0.943（每1岁），95%CI 0.910 - 0.978，P = 0.0013]中，FLD与年龄均呈负相关。匹配后，与非FLD组相比，患有FLD的A型患者发病时空气质量指数（AQI）较低，为68.5[四分位间距（IQR）46.0 - 90.0]，PM2.5浓度较低，为36.0μg/m³（IQR 23.0 - 56.0）。在Kaplan - Meier估计中，FLD与B型AAD患者较高的住院死亡风险相关（P = 0.0297）。在A型和B型AAD中，FLD在AAD中的患病率均随年龄降低。与非FLD组相比，患有FLD的A型AAD患者发病时空气质量参数更好。FLD与B型AAD患者较高的住院死亡风险相关。
