Fig. 1Prevalence of left ventricular diastolic dysfunction. (A) Prevalence according to sonographic grade of steatosis. (B) Prevalence according to presence of liver fibrosis predicted by non-alcoholic fatty liver disease fibrosis score. P for trend by chi-square test for linear-by-linear association. Pairwise comparisons corrected by Holm-Bonferroni method.
Fig. 2Adjusted odds ratio for left ventricular diastolic dysfunction by presence of non-alcoholic fatty liver disease (NAFLD). (A) Multivariable logistic regression in all subjects. Model 1, unadjusted; model 2, adjusted for age, sex, and body mass index (BMI); model 3, further adjusted for hypertension, smoking status, diabetes mellitus duration, fasting glucose, triglyceride, high density lipoprotein cholesterol, and alanine transaminase; model 4, further adjusted for insulin resistance. (B) Subgroup analyses and their interactions with NAFLD. Multivariable logistic regression with full model (model 4). OR, odds ratio; CI, confidence interval; HbA1c, glycosylated hemoglobin.
Fig. 3Adjusted odds ratio for left ventricular diastolic dysfunction by presence of liver fibrosis predicted by non-alcoholic fatty liver disease (NAFLD) fibrosis score. (A) Multivariable logistic regression in all subjects. Model 1, unadjusted; model 2, adjusted for age, sex, and body mass index (BMI); model 3, further adjusted for hypertension, smoking status, diabetes mellitus duration, fasting glucose, triglyceride, high-density lipoprotein-cholesterol, and alanine transaminase; model 4, further adjusted for insulin resistance. (B) Subgroup analyses and their interactions with liver fibrosis. Multivariable logistic regression with full model (model 4). OR, odds ratio; CI, confidence interval; HbA1c, glycosylated hemoglobin.
Table 1Clinical and echocardiographic parameters
Variable |
No NAFLD (n=251) |
NAFLD (n=355) |
P value |
Age, yr |
63.9±7.3 |
62.5±6.7 |
0.013 |
Sex |
|
|
0.108 |
Male |
68 (27.1) |
75 (21.1) |
Female |
183 (72.9) |
280 (78.9) |
BMI, kg/m2
|
24.8±3.4 |
26.8±3.3 |
<0.001 |
Waist circumference, cm |
83.7±8.0 |
88.8±8.2 |
<0.001 |
Systolic BP, mm Hg |
146.4±18.6 |
146.9±16.7 |
0.724 |
Diastolic BP, mm Hg |
87.4±11.4 |
90.0±11.1 |
0.006 |
Smoking |
|
|
0.286 |
Never |
203 (80.9) |
304 (85.6) |
Past |
35 (13.9) |
36 (10.1) |
Current |
13 (5.2) |
15 (4.2) |
Exercise |
91 (36.3) |
107 (30.1) |
0.135 |
Duration of diabetes mellitus, yr |
9.5±7.7 |
7.7±6.4 |
0.001 |
Hypertension |
150 (59.8) |
207 (58.3) |
0.784 |
Metabolic syndrome |
195 (77.7) |
326 (91.8) |
<0.001 |
Glucose, mmol/L |
8.58±3.20 |
8.52±2.79 |
0.806 |
HbA1c, % (mmol/mol) |
8.1±1.7 (65±19) |
8.3±1.7 (67±19) |
0.127 |
Insulin, pmol/L |
55.2±35.9 |
67.5±41.2 |
<0.001 |
C-peptide, nmol/L |
0.589±0.290 |
0.749±0.313 |
<0.001 |
KITT, %/min |
2.1±0.9 |
1.8±0.7 |
<0.001 |
Insulin resistance |
175 (69.7) |
296 (83.4) |
<0.001 |
Total cholesterol, mmol/L |
5.13±1.11 |
5.42±1.10 |
0.002 |
Triglyceride, mmol/L |
1.47±0.79 |
2.05±1.30 |
<0.001 |
HDL-C, mmol/L |
1.34±0.35 |
1.29±0.31 |
0.068 |
LDL-C, mmol/L |
3.12±0.97 |
3.23±0.97 |
0.153 |
AST, U/L |
25.8±11.5 |
30.7±15.4 |
<0.001 |
ALT, U/L |
24.2±13.9 |
32.9±19.6 |
<0.001 |
LVEF, % |
70.7±6.1 |
70.1±6.5 |
0.221 |
IVSTd, cm |
1.06±0.24 |
1.10±0.27 |
0.023 |
PWTd, cm |
1.02±0.18 |
1.07±0.19 |
0.004 |
LV mass index, g/m2
|
69.5±22.2 |
74.1±22.3 |
0.014 |
LA diameter, cm |
3.99±0.49 |
4.10±0.50 |
0.007 |
Peak E |
0.70±0.17 |
0.66±0.15 |
0.005 |
Peak A |
0.83±0.18 |
0.85±0.17 |
0.186 |
E/A ratio |
0.88±0.38 |
0.80±0.22 |
0.001 |
Deceleration time, ms |
248.8±48.2 |
256.9±44.4 |
0.034 |
Diastolic dysfunction |
123 (49.0) |
212 (59.7) |
0.011 |