Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

Cardiovascular Diabetology

Yongin Cho¹  Eun Seok Kang²  Eun Jig Lee²  Seok Won Park²  Yong-ho Lee²  Bong-Soo Cha²  Byung-Wan Lee²  Hyeok-Hee Lee²  Kap Bum Huh³  Byung Wook Huh³  Young Ju Choi³ 

[1] Department of Endocrinology and Metabolism, Inha University School of Medicine;Department of Internal Medicine, Yonsei University College of Medicine;Huh’s Diabetes Center and the 21st Century Diabetes and Vascular Research Institute;

关键词: Atherosclerosis;    Hepatic fibrosis;    Metabolic syndrome;    Non-alcoholic fatty liver disease;    Non-alcoholic steatohepatitis;    Type 2 diabetes;   

DOI  :  10.1186/s12933-020-01064-x

来源: DOAJ

【 摘 要 】

Abstract Background There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes. Methods From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1–2 years. Ultrasonographic findings at baseline and after 6–8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression. Results Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6–8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025–1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005–2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087–5.458; p < 0.05). Conclusions Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.

【 授权许可】

Unknown