非酒精性脂肪肝与心血管事件的关系:一项倾向性评分匹配研究

Relationship between Nonalcoholic Fatty Liver Disease and Cardiovascular Events:a Propensity Score Matching Study Lin Jia-l

目的:研究非酒精性脂肪肝(NAFLD)与心血管事件的关系。方法:选取2021年1月—2022年1月广州医科大学附属第四医院内科住院患者372例为观察对象,根据是否存在NAFLD分为NAFLD组(n=89)及非NAFLD组(n=283),两组进行1∶1倾向性评分匹配(PSM)。比较PSM成功后两组患者肝脏转氨酶异常情况、冠状动脉粥样硬化程度、病变血管数及心力衰竭情况。结果:372例患者PSM后,两组各有61例患者,两组患者基线资料平衡。PSM后,NAFLD组天门冬氨酸氨基转移酶、丙氨酸氨基转移酶异常占比高于非NAFLD组,差异有统计学意义(P<0.05)。非NAFLD组冠状动脉硬化程度及病变冠状动脉数量情况优于NAFLD组,差异有统计学意义(P<0.05)。NAFLD组重度心力衰竭(Ⅳ级)患者比例及氨基末端脑钠肽前体水平高于非NAFLD组,差异有统计学意义(P<0.05)。结论:NAFLD与冠状动脉粥样硬化程度、病变血管数量及心力衰竭事件的严重程度显著相关,临床医生应重视NAFLD的早预防、早诊断及早治疗。

Objective:To investigate the relationship between nonalcoholic fatty liver disease(NAFLD)and cardiovascular events.Methods:A total of three hundred and seventy-two inpatients in the department of internal medicine of the Fourth Affiliated Hospital of Guangzhou Medical University from January 2021 to January 2022 were selected as the observation objects.According to the presence or absence of NAFLD,they were divided into NAFLD group(n=89)and non-NAFLD group(n=283).The two groups were evaluated with 1∶1 propensity score matching(PSM).The abnormal liver transaminase,degree of coronary atherosclerosis,number of diseased vessels and heart failure were compared between the two groups after PSM.Results:After 372 patients with PSM,there were 61 patients in each group,and baseline data were balanced between the two groups.After PSM,the abnormal proportion of aspartate aminotransferase and alanine aminotransferase in NAFLD group was higher than that in nonNAFLD group,and the difference was statistically significant(P<0.05).The degree of coronary atherosclerosis and the number of diseased coronary arteries in the non-NAFLD group were better than those in the NAFLD group,and the difference was statistically significant(P<0.05).The proportion of patients with severe heart failure(gradeⅣ)and the level of aminoterminal brain natriuretic peptide precursor in NAFLD group were higher than those in non-NAFLD group,and the difference was statistically significant(P<0.05).Conclusion:NAFLD is significantly correlated with the degree of coronary atherosclerosis,the number of diseased vessels and the severity of heart failure events.Clinicians should pay attention to the early prevention,diagnosis and treatment of NAFLD.