非酒精性脂肪肝伴2型糖尿病患者左室舒张功能的影响

The Influence of Non-alcoholic Fatty Liver Disease on Left Ventricular Diastolic Function in Type 2 Diabetic Patients.

目的探讨非酒精性脂肪肝（NAFLD）对2型糖尿病患者左室舒张功能的影响。方法纳入596例2型糖尿病住院患者,进行腹部超声、颈动脉超声、心脏超声等检查,以E/A作为评估左室舒张功能的指标,分为NAFLD组和非NAFLD组,组内或组间差异比较用单因素方差分析或χ^2检验,并采用多因素Logistic回归分析对可能影响舒张功能的因素进行分析。结果 2型糖尿病合并NAFLD组的BMI、收缩压、丙氨酸氨基转移酶、甘油三酯、LDL胆固醇、HbA1c、HOMA-IR、颈动脉内膜中层厚度显著高于无NAFLD组（P〈0.05）,E/A值显著低于无NAFLD组（P〈0.05）;NAFLD与左室舒张功能减退的相关性经多因素Logistic回归分析进行校正后OR值为1.72（95%CI 1.26～2.75,P〈0.05）。结论在2型糖尿病患者中,NAFLD是左室舒张功能减退的重要危险因素。

Objective To evaluate the influence of non-alcoholic fatty liver disease（ NAFLD） on left diastolic ventricular function in type 2 diabetes patients. Methods The type 2 diabetic patients were enrolled（ n = 596）,tests like abdomen ultrasound,carotid artery ultrasound,cardiac uhrasonography were cawied out. E /A was used as an index to evaluate the left ventricular diastolic dysfunction,and patients were divided into NAFLD group and non-NAFLD group. Using one-way ANOVA or chi-square test as a method to analyze the differences between two groups. Using multi-factor Logistic regression analysis to analyze the factors that may influence the left ventricular diastolic function. P〈0. 05 considered statistically significant. Results Body mass index,systolic pressure,alanine aminotransferase,triglyceride,low density lipoprotein cholesterin,HbA1 c,homeostasis model assessment of insulin resistance（ HOMA-IR）,intima-media thickness（ IMT） were significantly higher in individuals with NAFLD than in those without NAFLD（ P〈0. 05）. Patients with NAFLD had a remarkably lower E /A（ 0. 82 ±0. 18,P〈0. 05）. NAFLD remained independently associated with left ventricular dysfunction in multivariate logistic regression analysis（ Odds Ratio 1. 72,95% CI 1. 26 ～ 2. 75,P〈0. 05）. Conclusions NAFLD is an independent risk factor of decline of left ventricle diastole function in type 2 diabetes patients.