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中华肥胖与代谢病电子杂志

中华肥胖与代谢病电子杂志 ›› 2020, Vol. 06 ›› Issue (01) : 47 -50. doi: 10.3877/cma.j.issn.2095-9605.2020.01.010

所属专题： 专题评论； 文献；

论著

肥胖冠心病患者非酒精性脂肪肝与Gensini评分之间的关系
徐文静1,†(), 杨鸣宇1, 何航宇1   
  1. 1. 525100　化州，广东省化州市人民医院心血管内科
  • 收稿日期:2020-01-10 出版日期:2020-02-28
  • 通信作者: 徐文静

Relationship between non-alcoholic fatty liver and Gensini score in obese patients with coronary heart disease

Wenjing Xu1,†(), Mingyu Yang1, Hangyu He1   

  1. 1. Department of Cardiology, Huazhou People's Hospital, Guangdong Province, Huazhou 525100, China
  • Received:2020-01-10 Published:2020-02-28
  • Corresponding author: Wenjing Xu
  • About author:
    Corresponding author: Xu Wenjing, Emai:
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徐文静, 杨鸣宇, 何航宇. 肥胖冠心病患者非酒精性脂肪肝与Gensini评分之间的关系[J]. 中华肥胖与代谢病电子杂志, 2020, 06(01): 47-50.

Wenjing Xu, Mingyu Yang, Hangyu He. Relationship between non-alcoholic fatty liver and Gensini score in obese patients with coronary heart disease[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2020, 06(01): 47-50.

目的

探讨肥胖冠心病患者中非酒精性脂肪肝（NAFLD）与Gensini评分之间的关系。

方法

回顾性分析广东省化州市人民医院心血管内科于2016年1月至2019年12月行冠状动脉造影检查的超重或肥胖患者共367例，记录所有患者的的一般资料、生化指标、入院时的危险程度GRACE（the global registry of acute coronary events）评分及冠脉造影的Gensini评分，记录NAFLD超声和CT的评估结果。

结果

NAFLD组的UA和TG水平显著高于非NAFLD组，而HDL-C则显著低于非NAFLD组（P<0.001）；NAFLD组的Gensini评分显著高于非NAFLD组（t=6.504，P<0.001)，重度NAFLD患者的Gensini评分显著高于轻度和中度组（P<0.05）；肥胖冠心病患者合并NAFLD（OR：1.64，95%CI：1.17-1.95，P=0.002）是高Gensini评分的风险因素。

结论

肥胖冠心病患者中非酒精性脂肪肝的严重程度与Gensini评分呈正相关，非酒精性脂肪肝是冠脉严重病变的独立风险因素。

关键词: 冠心病, 肥胖, 非酒精性脂肪肝, Gensini评分, 风险因素
Objective

To investigate the relationship between non-alcoholic fatty liver and Gensini score in obese patients with coronary heart disease.

Methods

A retrospective analysis of a total of 367 overweight or obese patients undergoing coronary angiography in our hospital from January 2016 to December 2019. The general information, biochemical parameters, GRACE (the global registry of acute coronary events) score at admission and the Gensini score of coronary angiography were recorded for all patients, and the ultrasound and CT evaluation results of NAFLD were recorded.

Results

The levels of UA and TG in NAFLD group were significantly higher than those in non-NAFLD group, while HDL-C was significantly lower than that in non-NAFLD group (P< 0.001). The Gensini score of the NAFLD group was significantly higher than that of the non-NAFLD group (t= 6.504, P < 0.001), and the Gensini score of patients with severe NAFLD was significantly higher than that of the mild and moderate groups (P< 0.05). Obese coronary heart disease patients with NAFLD (OR: 1.64, 95% CI: 1.17-1.95, P= 0.002) is a risk factor for high Gensini score.

Conclusions

The severity of non-alcoholic fatty liver in obese patients with coronary heart disease is positively correlated with the Gensini score. Non-alcoholic fatty liver is an independent risk factor for severe coronary artery disease.

Key words: Coronary heart disease, Obesity, Non-alcoholic fatty liver, Gensini score, Risk factors.
表1 两组患者一般资料比较
组别 N（例） 年龄（岁） 性别（男/女） BMI（kg/m2） 高血压（%） 糖尿病（%） 病程（年）
NAFLD组 163 57.9±2.8 93/70 27.6±1.5 78（47.9） 24（14.7） 3.5±1.6
非NAFLD组 204 58.4±3.2 109/95 27.4±1.6 82(40.2) 26（12.7） 3.7±1.8
t/χ2值 ? 1.571 0.481 1.223 2.160 0.301 1.111
P值 ? 0.117 0.488 0.222 0.142 0.538 0.267
表2 两组肥胖冠心病患者的生化指标对比
指标 NAFLD组（n=163） 非NAFLD组（n=204） t值 P值
UA（U/L） 341.9±73.2 314.6±74.3 3.520 <0.001
血糖（mmol/L） 6.8±2.4 6.5±2.6 1.136 0.257
TG（mmol/L） 1.78±0.42 1.57±0.36 5.155 <0.001
HDL-C（mmol/L） 0.93±0.18 1.01±0.21 3.861 <0.001
LDL-C（mmol/L） 2.31±0.54 2.27±0.72 0.589 0.556
ALT（U/L） 32.1±13.2 31.7±11.5 0.310 0.757
AST（U/L） 28.5±14.3 29.6±13.2 0.764 0.445
表3 两组患者的GRACE和Gensini评分比较
组别 N（例） GRACE评分 Gensini评分
NAFLD组 163 101.6±18.6 58.2±17.5
非NAFLD组 204 100.3±17.8 47.3±14.6
t值 ? 0.681 6.504
P值 ? 0.496 <0.001
表4 NAFLD患者病情分级其Gensini评分对比（n=163）
组别 N（例） Gensini评分
轻度 51 51.9±15.4
中度 73 59.3±18.1
重度 39 64.4±19.6
F值 ? 7.356
P值 ? <0.001
表5 NAFLD患者病情分级其Gensini评分对比（n=163）
变量 OR值 95%CI P值
NAFLD 1.64 1.17-1.95 0.002
UA 1.92 1.23-2.29 <0.001
血糖 1.15 0.82-1.45 0.157
TG 1.52 1.07-1.84 0.025
HDL-C 0.76 0.59-0.96 0.037
LDL-C 1.24 0.97-1.53 0.089
[1]
Cruise SM, Hughes J, Bennett K, et al. The Impact of Risk Factors for Coronary Heart Disease on Related Disability in Older Irish Adults[J]. J Aging Health, 2019, 31(1): 165-184.
[2]
Sookoian S, Pirola CJ. Systematic review with meta-analysis: risk factors for non-alcoholic fatty liver disease suggest a shared altered metabolic and cardiovascular profile between lean and obese patients[J]. Aliment Pharmacol Ther, 2017, 46(2): 85-95.
[3]
Ades PA, Savage PD. Obesity in coronary heart disease: an unaddressed behavioral risk factor[J]. Prev Med, 2017, 104: 117-119.
[4]
Shakiba M, Mansournia MA, Salari A, et al. Accounting for Time-varying Confounding in the Relation between Obesity and Coronary Heart Disease: Analysis with G-estimation: the ARIC study[J]. Am J Epidemiol, 2018, 187(6): 1319-1326.
[5]
Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study[J]. Ann Hepatol, 2007, 6(3): 161-163.
[6]
Das K, Das K, Mukherjee PS, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease[J]. Hepatology, 2010, 51(5): 1593-1602.
[7]
Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease[J]. N Engl J Med, 2010, 363(14): 1341-1350.
[8]
Bastien M, Poirier P, Lemieux I, et al. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis[J]. 2014, 56(4): 369-381.
[9]
沈卫峰，张奇，张瑞岩, 等. 2015年急性st段抬高型心肌梗死诊断和治疗指南解析[J]. 国际心血管病杂志, 2015, 42(4): 217-219.
[10]
中华医学会肝病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南(2010年修订版)[J]. 胃肠病学和肝病学杂志, 2010, 19(6): 483-487.
[11]
Kanwar P, Nelson JE, Yates K, et al. Association between metabolic syndrome and liver histology among NAFLD patients without diabetes[J]. BMJ Open Gastroenterol, 2016, 3(1): e000114.
[12]
Saokaew S, Kanchanasuwan S, Apisarnthanarak P, et al. Clinical risk scoring for predicting non-alcoholic fatty liver disease in metabolic syndrome patients (NAFLD-MS score)[J]. Liver Int, 2017, 37(10): 1535-1543.
[13]
Ballestri S, Lonardo A, Bonapace S, et al. Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease[J]. World J Gastroenterol, 2014, 20(7): 1724-1745.
[14]
Cho YK, Kang YM, Yoo JH, et al. The impact of non-alcoholic fatty liver disease and metabolic syndrome on the progression of coronary artery calcifification[J]. Sci Rep, 2018, 8(1): 12004.
[15]
Perera N, Indrakumar J, Abeysinghe WV, et al. Non alcoholic fatty liver disease increases the mortality from acute coronary syndrome: an observational study from Sri Lanka[J]. BMC Cardiovasc Disord. 2016, 16(16): 37.
[16]
Nurkalem Z, Hasdemir H, Ergelen M, et al. The relationship between glucose tolerance and severity of coronary artery disease using the Gensini score[J]. Angiology, 2010, 61(8): 751-755.
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