超声三维斑点追踪技术评价非酒精性脂肪性肝病合并2型糖尿病患者左心功能研究*

doi:10.3969/j.issn.1672-5069.2022.05.014

Abstract

Abstract: Objective The aim of this study was to explore the evaluation of left ventricular functions by three-dimensional speckle tracking imaging (3D-STI) in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods 60 patients with NAFLD and T2DM (mild NAFLD in 30 and severe in 30) and 30 patients with T2DM were admitted in our hospital between June 2019 and June 2021. Serum fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were detected. The left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs) and ratio of peak systolic velocity to end-diastolic velocity (E/A) were measured by routine two-dimensional ultrasound. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI) were measured by real-time three-dimensional ultrasound. The left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and global area strain (GAS) were detected by 3D-STI. Results Serum HbA1c, ALT and AST levels in patients with severe NAFLD and T2DM were (8.9±2.4)%,(127.2±16.9)U/L and (91.2±11.5)U/L, significantly higher than[(7.2±2.9)%, (61.6±10.4)U/L and (60.7±9.6)U/L, respectively, P<0.05] in patients with mild NAFLD and T2DM or [(7.0±2.5)%, (31.7±5.5)U/L and (33.5±4.8)U/L, respectively, P<0.05] in patients with T2DM; there were no significant differences in LVDd, LVDs, ratio of E/A, LVEF, LVEDV, LVESV and LVMI among the three groups (P＞0.05); the GLS, GCS, GRS and GAS in patients with severe NAFLD and T2DM were (14.3±3.9)%, (17.3±3.3)%, (40.6±6.2)% and (24.1±4.6)%, significantly lower than [(17.7±2.8)%, (19.4±2.7)%, (44.9±8.7)% and (27.0±4.4)%, respectively, P<0.05] in patients with mild NAFLD and T2DM or [(18.9±2.4)%, (19.6±3.1)%, (45.5±6.4)% and (28.8±3.6)%, respectively, P<0.05] in patients with T2DM. Conclusion The 3D-STI detection could sensitively reflect changes of left ventricular functions in patients with NAFLD and T2DM, which is beneficial to correctly evaluate impairment of cardiac functions in this setting.

Key words: Non-alcoholic fatty liver disease, Type 2 diabetes mellitus, Left ventricular functions, Three-dimensional speckle tracking imaging, Strain parameter

Xi Jiaying, Tang Jiamei, Liu Lingyu, et al.. Evaluation of left ventricular functions by three-dimensional speckle tracking imaging in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus[J]. Journal of Practical Hepatology, 2022, 25(5): 661-664.

References

[1]Schonfels W, Beckmann JH, Ahrens M, et al. Histologic improvement of NAFLD in patients with obesity after bariatric surgery based on standardized NAS (NAFLD activity score). Surg Obes Relat Dis, 2018, 14(10):1607-1616.
[2]梁小丽,邝继孙,刘秋莉,等.非诺贝特联合热量限制饮食治疗非酒精性脂肪性肝病合并2型糖尿病患者疗效研究.实用肝脏病杂志,2021,24(1):51-54.
[3]Koch LK, Yeh MM. Nonalcoholic fatty liver disease (NAFLD): diagnosis, pitfalls, and staging. Ann Diagn Pathol, 2018, 37(1):83-90.
[4]Eslam M , Valenti L , Romeo S . Genetics and epigenetics of NAFLD and NASH: Clinical impact. J Hepatol, 2018, 28(2):268-279.
[5]Khan RS, Bril F, Cusi K, et al. Modulation of insulin resistance in nonalcoholic fatty liver disease. Hepatology, 2019, 70(2):711-724.
[6]Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev, 2017, 49(2):197-211.
[7]中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南(2018更新版).实用肝脏病杂志,2018,21(2):177-186.
[8]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版).中华糖尿病杂志,2018,10(1):4-67.
[9]Targher G, Byrne CD, Tilg H. NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications. Gut, 2020, 69(9):1691-1705.
[10] Cassidy S, Hallsworth K, Thoma C,et al. Cardiac structure and function are altered in type 2 diabetes and non-alcoholic fatty liver disease and associate with glycemic control. Cardiovasc Diabetol, 2015, 14(1):23.
[11] 孙娟娟, 王志斌, 何香芹,等. 三维斑点追踪成像评价血压控制程度对高血压患者早期收缩功能的影响. 中华高血压杂志, 2019, 27(3):283-286.
[12] Tanase DM, Gosav EM, Costea CF,et al. The intricate relationship between type 2 diabetes mellitus (T2DM), insulin resistance (IR), and nonalcoholic fatty liver disease (NAFLD). J Diabetes Res, 2020, 2020(1):3920196.
[13] Lee H, Kim G, Choi YJ,et al. Association between non-alcoholic steatohepatitis and left ventricular diastolic dysfunction in type 2 diabetes mellitus. Diabetes Metab J, 2020, 44(2):267-276.
[14] Chang W, Wang Y, Sun L,et al. Evaluation of left atrial function in type 2 diabetes mellitus patients with nonalcoholic fatty liver disease by two-dimensional speckle tracking echocardiography. Echocardiography, 2019, 36(7):1290-1297.
[15] Mantovani A, Pernigo M, Bergamini C,et al. Nonalcoholic fatty liver disease is independently associated with early left ventricular diastolic dysfunction in patients with type 2 diabetes. PLoS One, 2015, 10(8):e0135329.
[16] 南月敏,付娜,李文聪,等.2017美国非酒精性脂肪性肝病诊断与管理指南解读.中华肝脏病杂志,2017,25(9):687-694.
[17] Yu C, Wang L, Xue H,et al. Association of glycated hemoglobin with the risk of advanced fibrosis in non-alcoholic fatty liver disease patients without diabetes. Clin Res Hepatol Gastroenterol, 2019, 43(1):58-66.
[18] Shi C, Wang LJ, Hu DF,et al. Prevalence, clinical characteristics and outcome in patients with chronic heart failure and diabetes. Chin Med J (Engl), 2010, 123(6):646-650.
[19] Trovato FM, Martines GF, Catalano D,et al. Echocardiography and NAFLD (non-alcoholic fatty liver disease). Int J Cardiol, 2016, 221(1):275-279.
[20] 余珊珊,孙露,韩东刚,等.超声三维斑点追踪技术检查肝硬化患者左心室收缩功能初步研究.实用肝脏病杂志,2018,21(2):245-248.
[21] VanWagner LB, Wilcox JE, Colangelo LA,et al. Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: A population-based study. Hepatology, 2015, 62(3):773-783.
[22] Karabay CY, Kocabay G, Kalayci A,et al. Impaired left ventricular mechanics in nonalcoholic fatty liver disease: a speckle-tracking echocardiography study. Eur J Gastroenterol Hepatol, 2014, 26(3):325-331.

Evaluation of left ventricular functions by three-dimensional speckle tracking imaging in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus

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