Nonalcoholic fatty liver disease, diastolic dysfunction, and impaired myocardial glucose uptake in patients with type 2 diabetes

Minyoung Lee, Kwang Joon Kim, Tae Ha Chung, Jaehyun Bae, Yong ho Lee, Byung Wan Lee, Bong Soo Cha, Mijin Yun, Eun Seok Kang

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To investigate whether degree of nonalcoholic fatty liver disease (NAFLD) is associated with myocardial dysfunction related to impaired myocardial glucose uptake in patients with type 2 diabetes. Materials and methods: In total, 131 patients with type 2 diabetes from a tertiary care hospital were included in this study. Myocardial glucose uptake was assessed using [18F]-fluorodeoxyglucose-positron emission tomography. Hepatic steatosis and fibrosis were determined using transient liver elastography. Echocardiography was performed to evaluate cardiac structure and function. Results: Patients with NAFLD had cardiac diastolic dysfunction with higher left ventricular filling pressure (E/e' ratio) and left atrial (LA) volume index than patients without NAFLD (all P < 0.05). Hepatic steatosis correlated with E/e' ratio and LA volume index, and hepatic fibrosis also correlated with E/e' ratio (all P < 0.05). Even after adjusting for confounding factors, a higher degree of hepatic steatosis (r2 = 0.409, P = 0.041) and a higher degree of fibrosis (r2 = 0.423, P = 0.009) were independent contributing factors to a higher E/e' ratio. Decreased myocardial glucose uptake was associated with a higher degree of steatosis (P for trend = 0.084) and fibrosis (P for trend = 0.012). At the same time, decreased myocardial glucose uptake was an independent contributing factor for a higher E/e' ratio (r2 = 0.409; P = 0.040). Conclusions: Hepatic steatosis and fibrosis were significantly associated with diastolic heart dysfunction in patients with type 2 diabetes coupled with impaired myocardial glucose uptake.

Original languageEnglish
Pages (from-to)1041-1051
Number of pages11
JournalDiabetes, Obesity and Metabolism
Volume23
Issue number4
DOIs
Publication statusPublished - 2021 Apr

Bibliographical note

Funding Information:
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP), Grant/Award Number: NRF‐2019R1A2C2007514 Funding information

Funding Information:
This study was supported by the “Data Science Centre” of the Yonsei University College of Medicine, Seoul, Korea, with regard to data curation. The authors thank Medical Illustration & Design (MID), a part of the Medical Research Support Services of Yonsei University College of Medicine, for providing excellent support with medical illustration.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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