Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Physical Examination Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2022 Nov 16;13:947914. doi: 10.3389/fendo.2022.947914. eCollection 2022.
Glucose and lipoprotein(a) [Lp(a)] have been recognized risk factors for atherosclerosis. The impact of both factors on fatty liver patients has not been studied. The aim of this study is to explore the role of high-level Lp(a) and different glucose metabolism statuses on carotid plaques in fatty liver patients.
We selected 4,335 fatty liver patients in this cross-sectional study. The diagnosis of fatty liver disease and carotid plaques was made by ultrasound. Participants were divided into four groups based on glucose metabolism status (normal glucose regulation [NGR], lower bound of impaired fasting glucose [IFG-L], higher bound of impaired fasting glucose [IFG-H], diabetes mellitus [DM]) and then categorized into 12 subgroups according to Lp(a) concentrations. The association between variables was estimated by odds ratio (OR).
Carotid plaques were present in 1,613 (37.2%) fatty liver patients. Lp(a)≥30 mg/dL was associated with high risk of carotid plaques in those patients with IFG-L, IFG-H and DM (OR 1.934 [95% CI 1.033-3.618], 2.667 [1.378-5.162], 4.000 [2.219-7.210], respectively; <0.05). Fatty liver patients with DM plus Lp(a)<10 mg/dL and 10≤Lp(a)<30 mg/dL were more vulnerable to carotid plaques (OR 1.563 [95% CI 1.090-2.241], 1.930 [1.279-2.914]), respectively, <0.05).
Our study first suggested that high-level Lp(a) may raise the risk of carotid plaques in fatty liver patients with not only diabetes but also IFG, manifesting that Lp(a) may be helpful for the early discovery of subclinical atherosclerosis in fatty liver patients with impaired glucose metabolism.
葡萄糖和脂蛋白(a)[Lp(a)]已被认为是动脉粥样硬化的危险因素。这两个因素对脂肪肝患者的影响尚未得到研究。本研究旨在探讨高水平 Lp(a)和不同糖代谢状态对脂肪肝患者颈动脉斑块的作用。
本横断面研究共纳入 4335 例脂肪肝患者。通过超声检查诊断脂肪肝和颈动脉斑块。根据糖代谢状态（正常血糖调节[NGR]、空腹血糖受损低界[IFG-L]、空腹血糖受损高界[IFG-H]、糖尿病[DM]）将参与者分为 4 组，然后根据 Lp(a)浓度分为 12 个亚组。采用比值比（OR）估计变量之间的相关性。
在 1613 例（37.2%）脂肪肝患者中存在颈动脉斑块。在 IFG-L、IFG-H 和 DM 患者中，Lp(a)≥30mg/dL 与颈动脉斑块发生风险升高相关（OR 1.934[95%CI 1.033-3.618]、2.667[1.378-5.162]、4.000[2.219-7.210]；均<0.05）。合并 DM 且 Lp(a)<10mg/dL 和 10≤Lp(a)<30mg/dL 的脂肪肝患者发生颈动脉斑块的风险更高（OR 1.563[95%CI 1.090-2.241]、1.930[1.279-2.914]），均<0.05）。
本研究首次表明，高水平 Lp(a)可能会增加不仅患有糖尿病而且还患有 IFG 的脂肪肝患者发生颈动脉斑块的风险，表明 Lp(a)可能有助于发现糖代谢受损的脂肪肝患者亚临床动脉粥样硬化。
