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非肥胖成年人非酒精性脂肪肝与左心室舒张功能障碍的相关性:一项横断面研究。

Correlation between nonalcoholic fatty liver disease and left ventricular diastolic dysfunction in non-obese adults: a cross-sectional study.

机构信息

Geriatric Department, Peking University People's Hospital, Beijing, 100044, China.

出版信息

BMC Gastroenterol. 2023 Mar 27;23(1):90. doi: 10.1186/s12876-023-02708-4.

Abstract

BACKGROUND AND AIMS

Non-alcoholic fatty liver disease (NAFLD) is associated with a greater risk of developing cardiovascular disease and have adverse impacts on the cardiac structure and function. Little is known about the effect of non-obese NAFLD upon cardiac function. We aimed to compare the echocardiographic parameters of left ventricle (LV) between non-obese NAFLD group and control group, and explore the correlation of non-obese NAFLD with LV diastolic dysfunction.

METHODS AND RESULTS

In this cross-sectional study, 316 non-obese inpatients were enrolled, including 72 participants with NAFLD (non-obese NAFLD group) and 244 participants without NAFLD (control group). LV structural and functional indices of two groups were comparatively analyzed. LV diastolic disfunction was diagnosed and graded using the ratio of the peak velocity of the early filling (E) wave to the atrial contraction (A) wave and E value. Compared with control group, the non-obese NAFLD group had the lower E/A〔(0.80 ± 0.22) vs (0.88 ± 0.35), t = 2.528, p = 0.012〕and the smaller LV end-diastolic diameter〔(4.51 ± 0.42)cm vs (4.64 ± 0.43)cm, t = 2.182, p = 0.030〕. And the non-obese NAFLD group had a higher prevalence of E/A < 1 than control group (83.3% vs 68.9%, X = 5.802, p = 0.016) while two groups had similar proportions of LV diastolic dysfunction (58.3% vs 53.7%, X = 0.484, p = 0.487). Multivariate logistic regression analysis showed that non-obese NAFLD was associated with an increase in E/A < 1 (OR = 6.562, 95%CI 2.014, 21.373, p = 0.002).

CONCLUSIONS

Non-obese NAFLD was associated with decrease of E/A, while more research will be necessary to evaluate risk of non-obese NAFLD for LV diastolic dysfunction in future.

摘要

背景与目的

非酒精性脂肪性肝病(NAFLD)与心血管疾病风险增加相关,并对心脏结构和功能产生不良影响。关于非肥胖型 NAFLD 对心脏功能的影响知之甚少。本研究旨在比较非肥胖型 NAFLD 组和对照组的左心室(LV)超声心动图参数,并探讨非肥胖型 NAFLD 与 LV 舒张功能障碍的相关性。

方法与结果

本横断面研究纳入了 316 名非肥胖住院患者,其中 72 名参与者患有 NAFLD(非肥胖型 NAFLD 组),244 名参与者无 NAFLD(对照组)。对比分析两组的 LV 结构和功能指标。采用 E 波与 A 波峰值速度之比及 E 值诊断和分级 LV 舒张功能障碍。与对照组相比,非肥胖型 NAFLD 组的 E/A 比值更低〔(0.80±0.22)比(0.88±0.35),t=2.528,p=0.012〕,LV 舒张末期直径更小〔(4.51±0.42)cm 比(4.64±0.43)cm,t=2.182,p=0.030〕。非肥胖型 NAFLD 组 E/A<1 的发生率高于对照组(83.3%比 68.9%,X²=5.802,p=0.016),而两组 LV 舒张功能障碍的比例相似(58.3%比 53.7%,X²=0.484,p=0.487)。多变量 logistic 回归分析显示,非肥胖型 NAFLD 与 E/A<1 增加相关(OR=6.562,95%CI 2.014~21.373,p=0.002)。

结论

非肥胖型 NAFLD 与 E/A 降低相关,未来需要更多研究来评估非肥胖型 NAFLD 对 LV 舒张功能障碍的风险。

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