Metabolic dysfunction-associated steatotic liver disease-associated fibrosis and cardiac dysfunction in patients with type 2 diabetes

被引：2
作者：
Cernea, Simona [1 ,2 ]
Onisor, Danusia [1 ,3 ,4 ]
Roiban, Andrada Larisa [5 ,6 ]
Benedek, Theodora [7 ]
Rat, Nora
机构：
[1] George Emil Palade Univ Med & Pharm Sci & Technol, Dept M3 Internal Med 1, 38 Gheorghe Marinescu St, Targu Mures 540142, Romania
[2] Emergency Cty Clin Hosp, Diabet Nutr & Metab Dis Outpatient Unit, Targu Mures 540136, Romania
[3] George Emil Palade Univ Med Pharm Sci & Technol T, Dept ME2 Internal Med 7, Targu Mures 540142, Romania
[4] Mures Cty Clin Hosp, Gastroenterol Clin, Targu Mures 540103, Romania
[5] Medias Municipal Hosp, Diabet Compartment, Medias 551030, Romania
[6] George Emil Palade Univ Med Pharm Sci & Technol T, Doctoral Sch Med & Pharm, Targu Mures 540142, Romania
[7] George Emil Palade Univ Med Pharm Sci & Technol T, Dept M3 Internal Med 8, Targu Mures 540142, Romania
来源：
WORLD JOURNAL OF CARDIOLOGY | 2024年 / 16卷 / 10期
关键词：
Metabolic dysfunction-associated steatotic liver disease; Type 2 diabetes mellitus; Liver fibrosis; Cardiac dysfunction; Sex-hormone binding protein; RISK; MORTALITY; EVENTS; STAGE; SCORE;
D O I：
10.4330/wjc.v16.i10.580
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD), particularly in the presence of liver fibrosis, increases the risk of cardiovascular morbidity and mortality, but the nature of the cardio-hepatic interaction in the context type 2 diabetes mellitus (T2DM) is not fully understood. AIM To evaluate the changes in cardiac morphology and function in patients with T2DM and MASLD-associated liver fibrosis. METHODS T2DM patients with MASLD underwent a medical evaluation that included an assessment of lifestyle, anthropometric measurements, vital signs, an extensive laboratory panel, and a standard echocardiography. Liver fibrosis was evaluated using two scores [Fibrosis-4 (FIB4) and Non-alcoholic fatty liver disease-Fibrosis Score (NFS)], and subjects were classified as having advanced fibrosis, no fibrosis, or an indeterminate risk. The correlations between structural and functional cardiac parameters and markers of liver fibrosis were evaluated through bivariate and multiple regression analyses. Statistical significance was set at P < 0.05. RESULTS Data from 267 T2DM-MASLD subjects with complete assessment was analyzed. Patients with scores indicating advanced fibrosis exhibited higher interventricular septum and left ventricular (LV) posterior wall thickness, atrial diameters, LV end-systolic volume, LV mass index (LVMi), and epicardial adipose tissue thickness (EATT). Their mean ejection fraction (EF) was significantly lower (49.19% +/- 5.62% vs 50.87% +/- 5.14% vs 52.00% +/- 3.25%; P = 0.003), and a smaller proportion had an EF >= 50% (49.40% vs 68.90% vs 84.21%; P = 0.0017). Their total and mid LV wall motion score indexes were higher (P < 0.05). Additionally, they had markers of diastolic dysfunction, with a higher E/e' ratio [9.64 +/- 4.10 vs 8.44 (2.43-26.33) vs 7.35 +/- 2.62; P = 0.026], and over 70% had lateral e' values < 10 cm/second, though without significant differences between groups. In multiple regression analyses, FIB4 correlated with left atrium diameter (LAD; beta = 0.044; P < 0.05), and NFS with both LAD (beta = 0.039; P < 0.05) and right atrium diameter (beta = 0.041; P < 0.01), Moreover, LVMi correlated positively with age and EATT (beta = 1.997; P = 0.0008), and negatively with serum sex-hormone binding protein (SHBP) concentrations (beta = -0.280; P = 0.004). SHBP also correlated negatively with LAD (beta = -0.036; P < 0.05). CONCLUSION T2DM patients with markers of MASLD-related liver fibrosis exhibit lower EF and present indicators of diastolic dysfunction and cardiac hypertrophy. Additionally, LVMi and LAD correlated negatively with serum SHBP concentrations.
引用
收藏
页码：580 / 594
页数：16
相关论文
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