Myocardial fat accumulation is associated with cardiac dysfunction in patients with type 2 diabetes, especially in elderly or female patients: a retrospective observational study.
Myocardial fat accumulation is associated with cardiac dysfunction in patients with type 2 diabetes, especially in elderly or female patients: a retrospective observational study.
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心肌脂肪的积累与2型糖尿病患者的心脏功能障碍有关，尤其是在老年人或女性患者中：回顾性观察性研究。
DOI：
10.1186/s12933-023-01782-y
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发表时间：
2023-03-07
影响因子：
9.3
通讯作者：
中科院分区：
文献类型：
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作者：
异位脂肪是积聚在包括心肌在内的身体特定器官或隔室内或周围的脂肪。伴有心肌高脂肪积聚的2型糖尿病患者的临床特征尚不清楚。此外，关于2型糖尿病患者心肌脂肪积聚对冠状动脉疾病和心功能不全的影响还知之甚少。我们的目的是阐明2型糖尿病合并心肌脂肪积聚患者的临床特征，包括心功能。我们回顾了2000年1月至2021年3月期间接受心电门控冠状动脉CT血管造影(CCTA)和腹部计算机断层扫描(CT)检查的2型糖尿病患者。心肌高脂肪积聚被定义为三个感兴趣区域的低平均心肌CT值，并评估CT值与临床特征或心功能的关系。总共有124名患者入选(男性72名，女性52名)。平均年龄66.6岁，平均BMI 26.2 kg/m2，平均射血分数(EF)67.6%，平均心肌CT值47.7 Hounsfield单位。心肌CT值与EF呈显著正相关(r = 0.3644，p = 0.0004)。多元回归分析还显示心肌CT值与EF独立相关(估计值，0.304；95%可信区间(CI)0.092~0.517；p = 0.0056)。心肌CT值与体重指数、内脏脂肪面积、皮下脂肪面积呈显著负相关(r = −=0.1923，−=0.2654，-0.3569，p <； )。在年龄65岁或女性的 ≥ 患者中，心肌CT值不仅与EF呈显著正相关(r = 分别为0.3542和0.4085，p 和lt； )，而且与早期侧环组织多普勒速度(Lat e‘)也呈显著正相关(r = 分别为0.5148和0.5361，p 和lt； )。多元回归分析显示，心肌CT值与EF、Lat e‘独立相关(p <； 0.0 5)。2型糖尿病患者，尤其是有较多心肌脂肪的老年或女性患者，左心室收缩和舒张期功能障碍更为严重。减少心肌脂肪积聚可能是2型糖尿病患者的治疗目标。网上版载有补充材料，可在10.1186/s12933-023-01782-y查阅。
Ectopic fat is fat that accumulates in or around specific organs or compartments of the body including myocardium. The clinical features of type 2 diabetes patients with high fat accumulation in the myocardium remain unknown. Moreover, little is known about the influence of myocardial fat accumulation in type 2 diabetes on coronary artery disease and cardiac dysfunction. We aimed to clarify the clinical features, including cardiac functions, of type 2 diabetes patients with myocardial fat accumulation. We retrospectively enrolled type 2 diabetes patients who underwent ECG-gated coronary computed tomography angiography (CCTA) and abdominal computed tomography (CT) scan examinations within 1 year of CCTA from January 2000 to March 2021. High fat accumulation in the myocardium was defined as the low mean myocardial CT value of three regions of interest, and the associations between CT values and clinical characteristics or cardiac functions were assessed. In total, 124 patients were enrolled (72 males and 52 females). The mean age was 66.6 years, the mean BMI was 26.2 kg/m2, the mean ejection fraction (EF) was 67.6%, and the mean myocardial CT value was 47.7 Hounsfield unit. A significant positive correlation was found between myocardial CT value and EF (r = 0.3644, p = 0.0004). The multiple regression analyses also showed that myocardial CT value was independently associated with EF (estimate, 0.304; 95% confidence interval (CI) 0.092 to 0.517; p = 0.0056). Myocardial CT value showed significant negative correlations with BMI, visceral fat area and subcutaneous fat area (r = − 0.1923, − 0.2654, and -0.3569, respectively, p < 0.05). In patients who were ≥ 65 years or female, myocardial CT value showed significant positive correlations with not only EF (r = 0.3542 and 0.4085, respectively, p < 0.01) but also early lateral annular tissue Doppler velocity (Lat e’) (r = 0.5148 and 0.5361, respectively, p < 0.05). The multiple regression analyses showed that myocardial CT value was independently associated with EF and Lat e’ in these subgroups (p < 0.05). Patients with type 2 diabetes, especially in elderly or female patients, who had more myocardial fat had more severe left ventricular systolic and diastolic dysfunctions. Reducing myocardial fat accumulation may be a therapeutic target for type 2 diabetes patients. The online version contains supplementary material available at 10.1186/s12933-023-01782-y.
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影响因子：
3.9
作者：
通讯作者：
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DOI：
10.1186/s12968-016-0228-3
发表时间：
2016-02-05
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
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作者：
Liao PA;Lin G;Tsai SY;Wang CH;Juan YH;Lin YC;Wu MT;Yang LY;Liu MH;Chang TC;Lin YC;Huang YC;Huang PC;Wang JJ;Ng SH;Ng KK
通讯作者：
Ng KK
影响因子：
9.8
作者：
Marfella, Raffaele;D'Onofrio, Nunzia;Paolisso, Giuseppe
通讯作者：
Paolisso, Giuseppe
DOI：
10.1161/atvbaha.114.303035
发表时间：
2014-09
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
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作者：
Lim S;Meigs JB
通讯作者：
Meigs JB
影响因子：
9.3
作者：
通讯作者：
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