School of Clinical Medicine, Guizhou Medical University, Guiyang, China.
The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China.
Front Endocrinol (Lausanne). 2022 Jul 19;13:935390. doi: 10.3389/fendo.2022.935390. eCollection 2022.
Non-alcoholic fatty liver disease (NAFLD) is closely related to cardiovascular diseases (CVD). A newly proposed definition is metabolic dysfunction-associated fatty liver disease (MAFLD), which was changed from NAFLD. The clinical effect of this change on abnormalities of cardiac structure and function is yet unknown. We aimed to examine whether MAFLD is associated with left ventricular (LV) diastolic dysfunction (LVDD) and cardiac remolding and further identify the impact of different subgroups and severity of MAFLD.
We evaluated 228 participants without known CVDs. Participants were categorized by the presence of MAFLD and the normal group. Then, patients with MAFLD were subclassified into three subgroups: MAFLD patients with diabetes (diabetes subgroup), overweight/obesity patients (overweight/obesity subgroup), and lean/normal-weight patients who had two metabolic risk abnormalities (lean metabolic dysfunction subgroup). Furthermore, the severity of hepatic steatosis was assessed by transient elastography (FibroScan) with a controlled attenuation parameter (CAP), and patients with MAFLD were divided into normal, mild, moderate, and severe hepatic steatosis groups based on CAP value. Cardiac structure and function were examined by echocardiography.
LVDD was significantly more prevalent in the MAFLD group (24.6% vs. 60.8%, < 0.001) compared to the normal group. The overweight subgroup and diabetes subgroup were significantly associated with signs of cardiac remolding, including interventricular septum thickness, LV posterior wall thickness, left atrial diameter (all < 0.05), relative wall thickness, and LV mass index (all < 0.05). Additionally, moderate-to-to severe steatosis patients had higher risks for LVDD and cardiac remolding (all -values < 0.05).
MAFLD was associated with LVDD and cardiac remolding, especially in patients with diabetes, overweight patients, and moderate-to-to severe steatosis patients. This study provides theoretical support for the precise prevention of cardiovascular dysfunction in patients with MAFLD.
非酒精性脂肪性肝病（NAFLD）与心血管疾病（CVD）密切相关。一个新提出的定义是代谢功能障碍相关脂肪性肝病（MAFLD），它是从 NAFLD 改变而来的。这种变化对心脏结构和功能异常的临床效果尚不清楚。我们旨在研究 MAFLD 是否与左心室（LV）舒张功能障碍（LVDD）和心脏重塑有关，并进一步确定不同亚组和 MAFLD 严重程度的影响。
我们评估了 228 名无已知 CVD 的参与者。参与者根据是否存在 MAFLD 和正常组进行分类。然后，将 MAFLD 患者分为三组：糖尿病患者（糖尿病亚组）、超重/肥胖患者（超重/肥胖亚组）和有两种代谢风险异常的瘦/正常体重患者（瘦代谢功能障碍亚组）。此外，通过瞬时弹性成像（FibroScan）用受控衰减参数（CAP）评估肝脂肪变性的严重程度，根据 CAP 值将 MAFLD 患者分为正常、轻度、中度和重度肝脂肪变性组。通过超声心动图检查心脏结构和功能。
与正常组相比，MAFLD 组 LVDD 的发生率明显更高（24.6%比 60.8%，<0.001）。超重亚组和糖尿病亚组与心脏重塑迹象显著相关，包括室间隔厚度、LV 后壁厚度、左心房直径（均 <0.05）、相对壁厚度和 LV 质量指数（均 <0.05）。此外，中重度脂肪变性患者发生 LVDD 和心脏重塑的风险更高（所有 - 值<0.05）。
MAFLD 与 LVDD 和心脏重塑有关，特别是在糖尿病患者、超重患者和中重度脂肪变性患者中。本研究为 MAFLD 患者心血管功能障碍的精准预防提供了理论支持。
