Association between cardiac dysfunction and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Abstract

Objective To assess the association between cardiac dysfunction and nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Methods One hundred and nine patients with T2DM treated in Xinhua Hospital Diabetes and Endocrinology Ward from June, 2015 to December, 2015 were recruited in this study. Of the patients, 60 were diagnosed with NAFLD and 49 without by the controlled attenuation parameter(CAP). According to the CAP values, patients were divided into three groups: low CAP group (CAP<231 db/m, n=36), medium CAP group (231≤CAP<289 db/m, n=36) and high CAP group (CAP≥289 db/m, n=37). All patients underwent M-type/Doppler flow echocardiography to obtain cardiac structural and functional parameters. Data were compared between groups by using t or F test. Results It was found that patients with both T2DM and NAFLD had significantly lower peak early diastolic velocity measured at lateral mitral valve annulus(Em), and higher trans-mitral peak early diastolic velocity(E)/Em ratio and E/mean values of peak early diastolic velocity measured at both medial an lateral mitral valve annulus(Emean) ratio than patients without NAFLD (t=2.117, -2.164, -2.224, all P 0.05). Patients with high CAP have significantly lower Em, Emean, Em/peak late diastolic velocity measured at lateral mitral valve annulus(Am) ratio, and higher E/Em and E/Emean ratios than patients with low and medium CAP (F=3.876, 3.425, 2.933, 2.942, 3.303, all P 0.05). Conclusion NAFLD is a risk factor for cardiac diastolic dysfunction in patients with T2DM, but not for cardiac structural changes. Key words: Diabetes mellitus, type 2; Nonalcoholic fatty liver diseases; Left ventricular hypertrophy; Left ventricular diastolic dysfunction; Liver controlled attenuated parameter