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

• Published in: Diabetes, obesity & metabolism Vol. 23; no. 4; pp. 1041 - 1051
• Main Authors: Lee, Minyoung, Kim, Kwang Joon, Chung, Tae‐Ha, Bae, Jaehyun, Lee, Yong‐ho, Lee, Byung‐Wan, Cha, Bong‐Soo, Yun, Mijin, Kang, Eun Seok
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2021; Wiley Subscription Services, Inc
• Subjects: Diabetes; Diabetes mellitus (non-insulin dependent); diastolic heart dysfunction; Echocardiography; Fatty liver; Fibrosis; Glucose; Heart diseases; Insulin resistance; Liver diseases; liver fibrosis; nonalcoholic fatty liver disease; Positron emission tomography; Steatosis; Structure-function relationships; type 2 diabetes; Ventricle; liver fibrosis; nonalcoholic fatty liver disease; type 2 diabetes; positron emission tomography; insulin resistance; diastolic heart dysfunction
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.14310

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.