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非酒精性脂肪肝与心肌机电重构的荟萃分析。

Meta-Analysis of Non-Alcoholic Fatty Liver Disease and Electromechanical Reconstruction of Myocardium.

机构信息

Department of Medicine and Pediatrics, Medical Institute, Belgorod State University, Belgorod, Russia.

Department of Internal Medicine with a Course of Cardiology and Functional Diagnostics Named after V. S. Moiseev., Institution of Higher Professional Education, "Peoples' Friendship University of Russia" Moscow, Russia.

出版信息

Arch Razi Inst. 2022 Feb 28;77(1):135-140. doi: 10.22092/ARI.2021.356231.1808. eCollection 2022 Feb.

Abstract

In developed countries, non-alcoholic fatty liver disease (NAFLD), which results from obesity, has become endemic and kills many adults annually. Health research centers in most countries are looking to examine the relationship between metabolic syndrome (MetS) and metabolic biomarkers. A bleeding-prone standard liver biopsy or costly magnetic resonance imaging scan is used to diagnose NAFLD. The present study aimed to analyze medical databases using various scientific articles; moreover, this experiment analyzed medical databases using published scientific articles related to NAFLD, endovascular treatment, cardiac arrhythmias and conduction disorders, changes in the geometry of atria and ventricles, changes in myocardial mass volume as well as diastolic flow left and right ventricular systolic functions, coronary blood flow, analysis of the dependence of epicardial fat tissue (EFT) thickness, and the presence of chronic heart failure (CHF). It is demonstrated that the index of EFT in NAFLD positively correlated with the criteria of cardiovascular health, values of the carotid intima-media thickness, and calcification of the coronary arteries on the coronary artery calcium scale (<0.0001). The index of per EFT significantly correlated with the factor of the age of the NAFLD patients (=0.04), hemoglobin A1C level (<0.001), systemic inflammatory index (=0.02), the index of impaired glucose tolerance (=0.03), and especially, the patient's diabetes factor (<0.001). In addition, adiponectin levels were significantly lower in individuals with NAFLD (=0.001) and patients with MetS (=0.02). NAFLD in association with an increase in epicardial adipose tissue (EAT) is an independent risk factor for atherosclerosis, coronary heart disease, CHF, as well as structural and electrophysiological myocardial remodeling. The study of pathogenetic mechanisms in the context of the role of EAT and clinical monitoring of its condition are urgent problems of modern medicine.

摘要

在发达国家,由于肥胖引起的非酒精性脂肪性肝病(NAFLD)已普遍存在,每年导致许多成年人死亡。大多数国家的健康研究中心都在研究代谢综合征(MetS)和代谢生物标志物之间的关系。诊断 NAFLD 通常采用易出血的标准肝活检或昂贵的磁共振成像扫描。本研究旨在使用各种科学文章分析医学数据库;此外,该实验还使用与 NAFLD、血管内治疗、心律失常和传导障碍、心房和心室几何形状变化、心肌质量体积变化以及左、右心室收缩功能舒张期血流、冠状动脉血流相关的已发表科学文章分析医学数据库,分析心外膜脂肪组织(EFT)厚度的依赖性和慢性心力衰竭(CHF)的存在。结果表明,NAFLD 中的 EFT 指数与心血管健康标准、颈动脉内膜中层厚度值以及冠状动脉钙量表上冠状动脉钙化呈正相关(<0.0001)。每单位 EFT 的指数与 NAFLD 患者年龄(=0.04)、血红蛋白 A1C 水平(<0.001)、全身性炎症指数(=0.02)、葡萄糖耐量受损指数(=0.03)等因素显著相关,尤其是患者的糖尿病因素(<0.001)。此外,NAFLD 个体的脂联素水平显著降低(=0.001),MetS 患者的脂联素水平也显著降低(=0.02)。NAFLD 伴心外膜脂肪组织(EAT)增加是动脉粥样硬化、冠心病、心力衰竭以及结构性和电生理心肌重构的独立危险因素。在 EAT 作用的发病机制研究及其状况的临床监测方面,是现代医学的紧迫问题。

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