Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye. .
Department of First Aid and Emergency, Health Services Vocational School, Istanbul Nisantasi University, Istanbul, Turkey.
J Gastrointestin Liver Dis. 2024 Sep 29;33(3):348-354. doi: 10.15403/jgld-5533.
Non-alcoholic fatty liver disease (NAFLD) is related to an increased atherosclerotic cardiovascular disease (ASCVD) risk. This study investigated a potential relationship between liver fibrosis scores (LFS) reflecting NAFLD and ascending aortic dilatation (AAD).
This is an observational and cross-sectional study. Patients were consecutively enrolled from a cardiology clinic. The NAFLD fibrosis score (NFS), fibrosis-4 (FIB-4) index, aspartate aminotransferase (AST) to platelet ratio (APRI), and BARD scores of each patient were calculated. The ascending aortic diameters were evaluated by transthoracic echocardiography according to current clinical guidelines. The patients were allocated into two groups with and without AAD.
A total of 272 patients were included in the study. In AAD group, age, patients with hypertension (HT), coronary artery disease (CAD), FIB-4 index, BARD score and the NFS were significantly higher. As compared to the AAD group, body mass index (BMI), hemoglobin, and diuretic use were significantly higher in patients without aortic dilatation. The NFS with AAD, and NFS and FIB-4 index with indexed aortic diameter (AI) showed significant positive correlation (R=0.546, R=0.332, R=0.314 with p<0.001, respectively). In multivariate logistic regression analysis hemoglobin levels (OR=0.728, 95%CI: 0.553-0.958; p=0.023), BMI (OR=0.762, 95%CI: 0.668-0.869, p<0.001), HT (OR=3.269, 95%CI: 1.045-10.220; p=0.042), BARD score (OR=1.248, 95%CIL 0.815-1.955; p=0.044), and FIB-4 index (OR=2.432, 95%CI: 1.395-4.246; p=0.002) were found to be independently related to AAD.
Our study demonstrated a statistically significant relationship between NFS, FIB-4 index, BARD score and AAD. The presence of positive correlation among LFS and AAD in our study is remarkable. This may emphasize the increased risk of AAD in NAFLD.
非酒精性脂肪性肝病(NAFLD)与动脉粥样硬化性心血管疾病(ASCVD)风险增加有关。本研究旨在探讨反映 NAFLD 的肝纤维化评分(LFS)与升主动脉扩张(AAD)之间的潜在关系。
这是一项观察性、横断面研究。连续纳入心内科门诊患者。计算每位患者的 NAFLD 纤维化评分(NFS)、纤维化-4 指数(FIB-4)、天门冬氨酸氨基转移酶(AST)与血小板比值(APRI)和 BARD 评分。根据现行临床指南,通过经胸超声心动图评估升主动脉直径。将患者分为有和无 AAD 两组。
本研究共纳入 272 例患者。AAD 组患者年龄、高血压(HT)、冠心病(CAD)、FIB-4 指数、BARD 评分和 NFS 显著升高。与 AAD 组相比,无主动脉扩张患者的体重指数(BMI)、血红蛋白和利尿剂使用率较高。NFS 与 AAD 呈显著正相关(R=0.546,P<0.001),NFS 和 FIB-4 指数与索引升主动脉直径(AI)呈显著正相关(R=0.332,P<0.001;R=0.314,P<0.001)。多变量 logistic 回归分析显示,血红蛋白水平(OR=0.728,95%CI:0.553-0.958;P=0.023)、BMI(OR=0.762,95%CI:0.668-0.869,P<0.001)、HT(OR=3.269,95%CI:1.045-10.220;P=0.042)、BARD 评分(OR=1.248,95%CI:0.815-1.955;P=0.044)和 FIB-4 指数(OR=2.432,95%CI:1.395-4.246;P=0.002)与 AAD 独立相关。
本研究表明 NFS、FIB-4 指数、BARD 评分与 AAD 之间存在统计学显著关系。本研究中 LFS 与 AAD 之间存在正相关关系,这一点值得注意。这可能强调了 NAFLD 患者发生 AAD 的风险增加。