Simona Cernea, Andrada Larisa Roiban, Danusia Onișor, Nora Rat
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Correlations between the EATT and markers of liver fibrosis and steatosis were evaluated by bivariate and multiple regression analyses.</p><p><strong>Results: </strong>In this study population of 267 T2DM patients with MASLD, the median EATT value was 7 mm. 43.8% of study patients had an EATT >7 mm. The EATT was higher in patients with advanced liver fibrosis (8.97 ± 2.88 mm vs. 7.09 ± 2.38 mm; <i>p</i> < 0.0001) and in those with more severe hepatic steatosis (7.69 ± 2.70 mm vs. 6.61 ± 1.88 mm; <i>p</i> = 0.0310). A higher percentage of patients with advanced liver fibrosis had an EATT of >7 mm (68.3% vs. 36.7%; odds ratio (OR) = 3.72 [95% confidence interval (CI): 2.02; 6.87]; <i>p</i> < 0.0001). In the bivariate analyses, the EATT significantly correlated with the markers of body adiposity, non-invasive indexes of liver steatosis and fibrosis, aspartate aminotransferase (ASAT), gamma glutamyl transpeptidase (GGT), diabetes duration, and pO2. The multiple regression analyses indicated that the EATT was independently associated with fibrosis-4 (FIB-4) score and body fat mass, and with serum ferritin (in fully adjusted models), while the correlation with the markers of hepatic steatosis became non-significant after adjustments for body adiposity.</p><p><strong>Conclusion: </strong>T2DM patients with MASLD and markers of advanced liver fibrosis have higher EATT, which was independently associated with liver fibrosis.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39534"},"PeriodicalIF":1.3000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415757/pdf/","citationCount":"0","resultStr":"{\"title\":\"Epicardial Adipose Tissue and Liver Fibrosis in Patients With Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Liver Disease.\",\"authors\":\"Simona Cernea, Andrada Larisa Roiban, Danusia Onișor, Nora Rat\",\"doi\":\"10.31083/RCM39534\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Epicardial adipose tissue (EAT) is an indicator of high cardiovascular and metabolic risk. This study aimed to investigate the association between EAT thickness (EATT) and liver fibrosis and steatosis in patients with type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>Patients with T2DM and MASLD underwent a complex evaluation, which included clinical, laboratory, and liver and transthoracic cardiac ultrasound assessments. The EATT was measured using the standard method. Liver fibrosis and steatosis were evaluated by several non-invasive indexes, through which patients with severe steatosis and advanced fibrosis were identified. Correlations between the EATT and markers of liver fibrosis and steatosis were evaluated by bivariate and multiple regression analyses.</p><p><strong>Results: </strong>In this study population of 267 T2DM patients with MASLD, the median EATT value was 7 mm. 43.8% of study patients had an EATT >7 mm. The EATT was higher in patients with advanced liver fibrosis (8.97 ± 2.88 mm vs. 7.09 ± 2.38 mm; <i>p</i> < 0.0001) and in those with more severe hepatic steatosis (7.69 ± 2.70 mm vs. 6.61 ± 1.88 mm; <i>p</i> = 0.0310). A higher percentage of patients with advanced liver fibrosis had an EATT of >7 mm (68.3% vs. 36.7%; odds ratio (OR) = 3.72 [95% confidence interval (CI): 2.02; 6.87]; <i>p</i> < 0.0001). In the bivariate analyses, the EATT significantly correlated with the markers of body adiposity, non-invasive indexes of liver steatosis and fibrosis, aspartate aminotransferase (ASAT), gamma glutamyl transpeptidase (GGT), diabetes duration, and pO2. 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引用次数: 0
摘要
背景：心外膜脂肪组织（EAT）是高心血管和代谢风险的指标。本研究旨在探讨2型糖尿病（T2DM）和代谢功能障碍相关脂肪变性肝病（MASLD）患者的EAT厚度（EATT）与肝纤维化和脂肪变性之间的关系。方法：T2DM和MASLD患者接受了复杂的评估，包括临床、实验室、肝脏和经胸心脏超声评估。采用标准方法测定EATT。通过几种无创指标评估肝纤维化和脂肪变性，通过这些指标识别严重脂肪变性和晚期纤维化患者。通过双变量和多元回归分析评估EATT与肝纤维化和脂肪变性标志物之间的相关性。结果：在本研究的267例T2DM合并MASLD患者中，EATT的中位值为7 mm， 43.8%的研究患者EATT为70 mm。晚期肝纤维化患者的EATT（8.97±2.88 mm比7.09±2.38 mm, p < 0.0001）和重度肝脂肪变性患者的EATT（7.69±2.70 mm比6.61±1.88 mm, p = 0.0310）更高。晚期肝纤维化患者EATT为bb0.7 mm的比例较高（68.3% vs. 36.7%），优势比(OR) = 3.72[95%可信区间（CI）： 2.02；6.87);P < 0.0001)。在双变量分析中，EATT与身体肥胖、肝脂肪变性和纤维化的非侵入性指标、天冬氨酸转氨酶（ASAT）、γ谷氨酰转肽酶（GGT）、糖尿病病程和pO2显著相关。多元回归分析显示，EATT与纤维化-4 （FIB-4）评分、体脂量以及血清铁蛋白独立相关（在完全调整模型中），而与肝脂肪变性标志物的相关性在调整体脂后变得不显著。结论：T2DM合并MASLD及晚期肝纤维化标志物患者EATT较高，与肝纤维化独立相关。
Epicardial Adipose Tissue and Liver Fibrosis in Patients With Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Liver Disease.
Background: Epicardial adipose tissue (EAT) is an indicator of high cardiovascular and metabolic risk. This study aimed to investigate the association between EAT thickness (EATT) and liver fibrosis and steatosis in patients with type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD).
Methods: Patients with T2DM and MASLD underwent a complex evaluation, which included clinical, laboratory, and liver and transthoracic cardiac ultrasound assessments. The EATT was measured using the standard method. Liver fibrosis and steatosis were evaluated by several non-invasive indexes, through which patients with severe steatosis and advanced fibrosis were identified. Correlations between the EATT and markers of liver fibrosis and steatosis were evaluated by bivariate and multiple regression analyses.
Results: In this study population of 267 T2DM patients with MASLD, the median EATT value was 7 mm. 43.8% of study patients had an EATT >7 mm. The EATT was higher in patients with advanced liver fibrosis (8.97 ± 2.88 mm vs. 7.09 ± 2.38 mm; p < 0.0001) and in those with more severe hepatic steatosis (7.69 ± 2.70 mm vs. 6.61 ± 1.88 mm; p = 0.0310). A higher percentage of patients with advanced liver fibrosis had an EATT of >7 mm (68.3% vs. 36.7%; odds ratio (OR) = 3.72 [95% confidence interval (CI): 2.02; 6.87]; p < 0.0001). In the bivariate analyses, the EATT significantly correlated with the markers of body adiposity, non-invasive indexes of liver steatosis and fibrosis, aspartate aminotransferase (ASAT), gamma glutamyl transpeptidase (GGT), diabetes duration, and pO2. The multiple regression analyses indicated that the EATT was independently associated with fibrosis-4 (FIB-4) score and body fat mass, and with serum ferritin (in fully adjusted models), while the correlation with the markers of hepatic steatosis became non-significant after adjustments for body adiposity.
Conclusion: T2DM patients with MASLD and markers of advanced liver fibrosis have higher EATT, which was independently associated with liver fibrosis.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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