Association between nonalcoholic fatty liver disease and left ventricular diastolic dysfunction: A 7-year retrospective cohort study of 3,380 adults using serial echocardiography

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & metabolism Pub Date : 2024-04-10 DOI:10.1016/j.diabet.2024.101534
Gyuri Kim , Tae Yang Yu , Jae Hwan Jee , Ji Cheol Bae , Mira Kang , Jae Hyeon Kim
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Abstract

Aim

Left ventricular diastolic dysfunction (LVDD) has been observed in people with nonalcoholic fatty liver disease (NAFLD) in cross-sectional studies but the causal relationship is unclear. This study aimed to investigate the impact of NAFLD and the fibrotic progression of the disease on the development of LVDD, assessed by serial echocardiography, in a large population over a 7-year longitudinal setting.

Methods

This retrospective cohort study included the data of 3,380 subjects from a medical health check-up program. We defined subjects having NAFLD by abdominal ultrasonography and assessed significant liver fibrosis by the aspartate transaminase (AST) to platelet ratio index (APRI), the NAFLD fibrosis score (NFS), and the fibrosis-4 (FIB-4) index. LVDD was defined using serial echocardiography. A parametric Cox proportional hazards model was used.

Results

During 11,327 person-years of follow-up, there were 560 (16.0 %) incident cases of LVDD. After adjustment for multiple risk factors, subjects with NAFLD showed an increased adjusted hazard ratio (aHR) of 1.21 (95 % confidence interval [CI]=1.02–1.43) for incident LVDD compared to those without. The risk of LV diastolic dysfunction increased progressively with increasing degree of hepatic steatosis (P < 0.001). Compared to subjects without NAFLD, the multivariable-aHR (95 % CI) for LVDD in subjects with APRI < 0.5 and APRI ≥ 0.5 were 1.20 (1.01–1.42) and 1.36 (0.90–2.06), respectively (P = 0.036), while other fibrosis prediction models (NFS and FIB-4 index) showed insignificant results.

Conclusions

This study demonstrated that NAFLD was associated with an increased risk of LVDD in a large cohort. More severe forms of hepatic steatosis and/or significant liver fibrosis may increase the risk of developing LVDD.

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非酒精性脂肪肝与左心室舒张功能障碍之间的关系:使用连续超声心动图对 3,380 名成年人进行的为期 7 年的回顾性队列研究
目的在横断面研究中观察到非酒精性脂肪肝(NAFLD)患者存在左心室舒张功能障碍(LVDD),但其中的因果关系尚不清楚。本研究旨在调查非酒精性脂肪肝及其纤维化进展对 LVDD 发展的影响,通过连续超声心动图对大量人群进行为期 7 年的纵向评估。我们通过腹部超声波检查定义了非酒精性脂肪肝受试者,并通过天冬氨酸转氨酶(AST)与血小板比值指数(APRI)、非酒精性脂肪肝纤维化评分(NFS)和纤维化-4(FIB-4)指数评估了明显的肝纤维化。低密度心血管病是通过连续超声心动图来定义的。结果在11,327人年的随访中,有560例(16.0%)LVDD病例。在对多种风险因素进行调整后,与非酒精性脂肪肝患者相比,非酒精性脂肪肝患者发生 LVDD 的调整后危险比 (aHR) 增加了 1.21(95 % 置信区间 [CI]= 1.02-1.43)。左心室舒张功能障碍的风险随着肝脂肪变性程度的增加而逐渐增加(P < 0.001)。与无非酒精性脂肪肝的受试者相比,APRI ≥ 0.5 和 APRI ≥ 0.5 的受试者发生 LVDD 的多变量-aHR(95 % CI)分别为 1.20 (1.01-1.42) 和 1.36 (0.90-2.06)(P = 0.036),而其他纤维化预测模型(NFS 和 FIB-4 指数)显示的结果并不显著。更严重的肝脂肪变性和/或明显的肝纤维化可能会增加罹患心血管疾病的风险。
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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
期刊介绍: A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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