中国临床医学2026，Vol.33Issue(3)：434-444,11.DOI:10.12025/j.issn.1008-6358.2026.20260142
脂肪肝对心脏结构和功能的影响:一项基于健康体检的横断面研究
Effect of fatty liver on cardiac structure and function:a cross-sectional study based on health examination
摘要
Abstract
Objective To investigate the cross-sectional associations between different fatty liver classifications and cardiac structure and function in people undergo health examination.Methods A total of 6 545 adults who underwent health examinations at the Health Management Center of Zhongshan Hospital,Fudan University between January 1 and December 31,2017,were retrospectively included.Demographic characteristics and laboratory data were collected.The hepatic steatosis was graded by ultrasonography.And patients with fatty liver were further stratified according to alanine aminotransferase(ALT)or aspartate aminotransferase(AST)levels,as well as the degree of liver fibrosis.Cardiac morphology and function were assessed by transthoracic echocardiography,and left ventricular geometric patterns were classified accordingly.Multivariate logistic regression analysis was performed to evaluate the associations between fatty liver classifications and cardiac abnormalities.Results There were 2 795 patients(42.7%)with fatty liver,of whom 832(29.8%)had significant cardiac structural alterations and 1 500(53.7%)had diastolic dysfunction.Severe fatty liver was risk factor for concentric remodeling and increased relative wall thickness(RWT),with odds ratios(ORs)of 1.27(P=0.012)and 1.27(P=0.009),respectively.Fatty liver accompanied by elevated ALT or AST was risk factor for concentric remodeling(OR=1.45,1.56;P=0.001,0.001),increased RWT(OR=1.48,1.57;P＜0.001,＜0.001),and diastolic dysfunction(OR=1.27,1.32;P=0.035,0.040),respectively.Fatty liver with liver fibrosis was risk factor for concentric remodeling(OR=1.83,P=0.046)and diastolic dysfunction(OR=2.64,P=0.034).Conclusions Advanced fatty liver,including severe hepatic steatosis,accompanied by elevated liver enzymes or liver fibrosis,could increase risks of cardiac remodeling and diastolic dysfunction,while systolic function is preserved.For patients with fatty liver,it is recommended to undergo regular ultrasonography examination.关键词
脂肪肝/心脏结构/心脏功能/肝酶/肝纤维化Key words
fatty liver/cardiac structure/cardiac function/liver enzyme/liver fibrosis分类
医药卫生引用本文复制引用
陈沛文,任星星,颜红梅,常薪霞,张晶,曾海銮,蒋晶晶..脂肪肝对心脏结构和功能的影响:一项基于健康体检的横断面研究[J].中国临床医学,2026,33(3):434-444,11.基金项目
国家自然科学基金(82200894).Supported by National Natural Science Foundation of China(82200894). （82200894）
