The liver-heart axis in patients with severe obesity: The association between liver fibrosis and chronic myocardial injury may be explained by shared risk factors of cardiovascular disease

IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Clinical biochemistry Pub Date : 2023-11-22 DOI:10.1016/j.clinbiochem.2023.110688
J. Young , K.A. Seeberg , K.M. Aakre , H. Borgeraas , N. Nordstrand , T. Wisløff , J. Hjelmesæth , T. Omland , J.K. Hertel
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Abstract

Background

Severe obesity is associated with increased risk of non-alcoholic fatty liver disease and cardiovascular disease. We hypothesized that liver fibrosis as quantified by the Enhanced Liver Fibrosis (ELF) test would be predictive of myocardial injury and fibrosis, expressed by higher concentrations of cardiac troponin T and I measured by high-sensitivity assays (hs-cTnT and hs-cTnI, respectively).

Material and methods

We performed cross-sectional analyses of baseline data from 136 patients (mean age 45 years, 38 % male) with severe obesity participating in the non-randomized clinical trial Prevention of Coronary Heart Disease in Morbidly Obese Patients (ClinicalTrials.gov NCT00626964). Associations between ELF scores, hs-cTnT, and hs-cTnI concentrations were assessed using linear regression analysis.

Results

ELF scores were associated with hs-cTnT in the unadjusted model (B 0.381, 95 % Confidence Interval [CI] 0.247, 0.514), but the association was attenuated upon adjustment for potential confounders (B −0.031, 95 % CI −0.155, 0.093). Similarly, for hs-cTnI, an observed association with ELF scores in the unadjusted model was attenuated upon adjustment for potential confounders ((B 0.432, 95 % CI 0.179, 0.685) and (B 0.069, 95 % CI −0.230, 0.367), respectively). Age, sex, hypertension, and estimated glomerular filtration rate were amongst the shared predictors of ELF score, hs-cTnT, and hs-cTnI that provided the univariable models with the highest R-squared and lowest Akaike Information Criterion values.

Conclusions

Contrary to our hypothesis, ELF score did not predict myocardial injury and fibrosis, but rather demonstrated that an association between liver fibrosis and myocardial injury and fibrosis may be explained by shared risk factors of cardiovascular disease.

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严重肥胖患者的肝心轴:肝纤维化与慢性心肌损伤之间的关联可能由心血管疾病的共同危险因素来解释。
背景:严重肥胖与非酒精性脂肪性肝病和心血管疾病的风险增加有关。我们假设,通过增强肝纤维化(ELF)测试量化的肝纤维化可以预测心肌损伤和纤维化,通过高敏感性心肌肌钙蛋白T和I (hs-cTnT和hs-cTnI)浓度表达。材料和方法:我们对136例重度肥胖患者(平均年龄45岁,38%男性)的基线数据进行了横断面分析,这些患者参加了预防病态肥胖患者冠心病的非随机临床试验(ClinicalTrials.gov NCT00626964)。使用线性回归分析评估ELF评分、hs-cTnT和hs-cTnI浓度之间的关系。结果:在未调整的模型中,ELF评分与hs-cTnT相关(B 0.381, 95%可信区间[CI] 0.247, 0.514),但在调整潜在混杂因素后,相关性减弱(B -0.031, 95% CI -0.155, 0.093)。同样,对于hs-cTnI,在调整潜在混杂因素后,未调整模型中观察到的与ELF评分的关联减弱(分别为(B 0.432, 95% CI 0.179, 0.685)和(B 0.069, 95% CI -0.230, 0.367))。年龄、性别、高血压和估计的肾小球滤过率是ELF评分、hs-cTnT和hs-cTnI的共同预测因子,它们为单变量模型提供了最高的r平方和最低的赤池信息标准值。结论:与我们的假设相反,ELF评分并不能预测心肌损伤和纤维化,而是表明肝纤维化与心肌损伤和纤维化之间的关联可以通过心血管疾病的共同危险因素来解释。
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来源期刊
Clinical biochemistry
Clinical biochemistry 医学-医学实验技术
CiteScore
5.10
自引率
0.00%
发文量
151
审稿时长
25 days
期刊介绍: Clinical Biochemistry publishes articles relating to clinical chemistry, molecular biology and genetics, therapeutic drug monitoring and toxicology, laboratory immunology and laboratory medicine in general, with the focus on analytical and clinical investigation of laboratory tests in humans used for diagnosis, prognosis, treatment and therapy, and monitoring of disease.
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