Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease: A matched case-control study.
Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease: A matched case-control study.
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DOI：
10.1097/md.0000000000027043
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发表时间：
2021-08-27
期刊：
影响因子：
1.6
通讯作者：
Ito H
中科院分区：
文献类型：
--
作者：
Ichikawa K;Miyoshi T;Osawa K;Miki T;Morimitsu Y;Akagi N;Nakashima M;Ito H
非酒精性脂肪性肝病（NAFLD）是心脏死亡的危险因素。冠状动脉ct血管造影中脂肪衰减指数表示冠状动脉周围脂肪组织（PCAT）衰减，反映冠状动脉周围炎症。我们的目的是研究PCAT衰减与NAFLD之间的关系。这是一项单中心队列研究，包括在2020年1月至12月期间因疑似稳定型冠状动脉疾病接受冠状动脉计算机断层血管造影的患者。分析了NAFLD患者（n = 78）和倾向评分匹配的非NAFLD患者（n = 78）的患者特征和冠状动脉ct血管造影结果。在左前降支（LAD）和右冠状动脉近40 mm段的Hounsfield单位（HU）评估PCAT衰减。NAFLD患者左冠状动脉和右冠状动脉PCAT平均衰减明显高于非NAFLD患者。当患者以LAD-PCAT中位衰减值为- 72.5 HU分为两组时，PCAT高衰减组男性较多(82% vs 67%, P =。028)和NAFLD患者(63% vs 37%, P =。001)与低PCAT衰减组相比。两组患者在年龄、体重指数、常规心血管危险因素或高危斑块的存在方面均无差异。在多因素logistic分析中，NAFLD与高PCAT衰减独立相关（优势比2.912,95%可信区间1.386 ~ 6.118,P = 0.005）。NAFLD与冠状动脉ct血管造影的高PCAT衰减有关。这一发现表明，冠状动脉周围炎症与NAFLD患者心脏死亡率增加有关。
Non-alcoholic fatty liver disease (NAFLD) is a risk factor for cardiac mortality. Pericoronary adipose tissue (PCAT) attenuation, expressed by the fat attenuation index on coronary computed tomography angiography, reflects pericoronary inflammation. We aimed to investigate the association between PCAT attenuation and NAFLD. This is a single-center cohort study comprising of patients who underwent coronary computed tomography angiography for suspected stable coronary artery disease between January and December 2020. Patient characteristics and coronary computed tomography angiography findings were analyzed between patients with NAFLD (n = 78) and a propensity score-matched cohort of patients without NAFLD (n = 78). PCAT attenuation was assessed in Hounsfield units (HU) of proximal 40-mm segments of the left anterior descending artery (LAD) and right coronary artery. The mean PCAT attenuation in LAD and right coronary artery were significantly higher in patients with NAFLD than those without NAFLD. When patients were divided into 2 groups using the median LAD-PCAT attenuation of −72.5 HU, the high PCAT attenuation group had more males (82% vs 67%, P = .028) and NAFLD patients (63% vs 37%, P = .001) compared to the low PCAT attenuation group. No differences in age, body mass index, conventional cardiovascular risk factors, or the presence of high-risk plaque were observed between the 2 groups. In the multivariate logistic analysis, NAFLD was independently associated with high PCAT attenuation (odds ratio 2.912, 95% confidence interval 1.386 to 6.118, P = .005). NAFLD is associated with high PCAT attenuation on coronary computed tomography angiography. This finding suggests that pericoronary inflammation is involved in the increased cardiac mortality in NAFLD patients.