Fatty liver and atherogenic dyslipidemia have opposite effects on diabetic micro- and macrovascular disease

医学 内科学 血脂异常 冠状动脉疾病 糖尿病 糖尿病性视网膜病变 大血管病 2型糖尿病 代谢综合征 视网膜病变 脂肪肝 心脏病学 胃肠病学 内分泌学 肥胖 疾病
作者
Michel P. Hermans,É. Bouenizabila,K. Daniel Amoussou-Guenou,Comlan Jules Gninkoun,Sylvie A. Ahn,Michel F. Rousseau
出处
期刊:Diabetes and Metabolic Syndrome: Clinical Research and Reviews [Elsevier]
卷期号:16 (10): 102613-102613 被引量:3
标识
DOI:10.1016/j.dsx.2022.102613
摘要

Non-alcoholic fatty liver (FL) is comorbid with obesity, metabolic syndrome and type 2 diabetes. Atherogenic dyslipidaemia (AD), frequent in FL, is associated with risk of micro- and macrovascular complications. Given the paradoxical ocular protection of FL in T2DM, we studied how FL modulates micro- and macrovascular complications as a function of AD.Cross-sectional factorial analysis of 744 diabetic patients in whom FL, identified by ultrasonography, was present in 68%. AD, defined by low HDL-C plus elevated TG, was present in 45%. Four groups were analysed as regards cardiometabolic features, micro-/macroangiopathies, cataract and ocular hypertonia: FL[-]AD[-] (n = 171); FL[-]AD[+] (n = 66); FL[+]AD[-] (n = 235); and FL[+]AD[+] (n = 272).Age, gender and glycemic control were similar across groups. Prevalence of overall macroangiopathy and coronary artery disease were higher in patients with AD, irrespective of FL. Overall macroangiopathy was higher, by 64% in FL[-]AD[+] and by 38% in FL[+]AD[+]. Coronary artery disease was higher, by 128%, in FL[-]AD[+], and by 67%, in FL[+]AD[+]. (Micro)albuminuria was more frequent (+55%) in FL[-] AD[+] compared to FL[-] AD[-]. Retinopathy prevalence was 35% in FL[-], unaffected by AD. Retinopathy frequency was much lower in FL[+], irrespective of AD, decreased by -47% in FL[+]AD[-] and -32% in FL[+]AD[+] (vs. FL[-]AD[-]). Ocular hypertonia was present in 13%, and its prevalence was also markedly lower (-31%) in FL[+]. Cataract frequency was 29%, also lesser in FL[+] (24% vs. 39%), irrespective of AD.Multi-level eye protection in diabetes is linked to non-alcoholic fatty liver independently of atherogenic dyslipidemia.

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