ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Cardiovascular Morbidity in Diabetic Non-Alcoholic Fatty Liver Disease (NAFLD) Using NAFLD Fibrosis Score as an Early Indicator
Erken Bir Gösterge Olarak Non-Alkolik Yağlı Karaciğer Hastalığı (NAYKH) Fibrozis Skoru Kullanılarak Diyabetik NAYKH'de Kardiyovasküler Morbidite
Received Date : 25 Jun 2020
Accepted Date : 29 Aug 2020
Available Online : 30 Sep 2020
Doi: 10.25179/tjem.2020-77679 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:314-320
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Rising prevalence of non-alcoholic fatty liver disease (NAFLD), its high incidence in diabetic patients, and global diabetes prevalence, underline the need to identify comorbidities in these patients impacting their quality of life and mortality.NAFLDis associated with increased risk, prevalence, and complications of cardiovascular diseases in diabetic and non-diabetics alike. The study aimed to establish a relationship between noninvasively assessed cardiovascular morbidity and NAFLD fibrosis score (NFS) in type 2 diabetes mellitus with NAFLD. Material and Methods: After ethical approval, the study was conducted (n=100) on patients <60 years of age, havingtype 2 diabetes mellitus, and no existing cardiovascular disease. All patients underwent anthropological and routine investigations, two-dimension (2D) echocardiography, and ultrasonographic confirmation of fatty liver disease. NAFLD was ascertained based on patient history and investigations. Findings of cardiovascular evaluation on 2D-echocardiography were assessed with reference to the NFS. Results: Median age of participants was 53.5 years. Body mass index (p<0.001), right carotid intima-media thickness (p=0.0124), and left ventricular dysfunction (p=0.0024) showed a significant association with NAFLD. The presence of both left ventricular diastolic dysfunction and significant variation of carotid intima-media thickness among mild, moderate, and severe NFS groups (p=0.0049) was observed. Patients with moderate- severe NFS had 6.38 times more risk of developing cardiovascular morbidities. Conclusion: In patients with type 2 diabetes and NAFLD, the NFS helps to identify those at high risk of cardiovascular disease, and patients needing further investigation. It provides clues on how non-invasive cardiovascular markers can be used in detecting cardiovascular morbidities.
ÖZET
Amaç: Non-alkolik yağlı karaciğer hastalığının (NAYKH) artan prevalansı, diyabetik hastalardaki yüksek insidansı ve küresel diyabet prevalansı, bu hastalarda yaşam kalitelerini ve mortalitelerini etkileyen komorbiditelerin belirlenmesi ihtiyacının altını çizmektedir. NAYKH, hem diyabetiklerde hem de diyabetik olmayanlarda artan kardiyovasküler hastalık riski, prevalansı ve komplikasyonları ile ilişkilidir. Bu çalışmada, NAYKH olan Tip 2 diabetes mellitusta noninvaziv olarak değerlendirilen kardiyovasküler morbidite ile NAYKH fibrozis skoru (NFS) arasında bir ilişki kurmak amaçlanmıştır. Gereç ve Yöntemler: Çalışma, etik onay sonrası, Tip 2 diabetes mellitusu olan ve kardiyovasküler hastalığı olmayan 60 yaşın altındaki hastalar üzerinde gerçekleştirildi (n=100). Tüm hastalarda antropolojik ve rutin araştırmalar, iki boyutlu (2D) ekokardiyografi ve yağlı karaciğer hastalığının ultrasonografik doğrulaması yapıldı. NAYKH, hasta öyküsü ve araştırmalara göre belirlendi. 2D ekokardiyografide kardiyovasküler değerlendirme bulguları NFS referans alınarak değerlendirildi. Bulgular: Katılımcıların medyan yaşı 53,5 idi. Beden kitle indeksi (p<0,001), sağ karotis intima-media kalınlığı (p=0,0124) ve sol ventrikül disfonksiyonu (p=0,0024) NAYKH ile anlamlı bir ilişki gösterdi. Hafif, orta ve şiddetli NFS grupları arasında hem sol ventrikül diyastolik disfonksiyon hem de karotis intima-media kalınlığında anlamlı varyasyon gözlendi (p=0,0049). Orta-şiddetli NFS'li hastalarda kardiyovasküler morbidite geliştirme riski 6,38 kat daha fazlaydı. Sonuç: Tip 2 diyabetli ve NAYKH'li hastalarda NFS, yüksek kardiyovasküler hastalık riski taşıyan ve daha fazla araştırmaya ihtiyaç duyan hastaların belirlenmesine yardımcı olur. Non-invaziv kardiyovasküler belirteçlerin kardiyovasküler morbiditelerin saptanmasında nasıl kullanılabileceğine dair ipuçları sağlar.
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