| Objective: To investigate the correlation between non-alcoholic fatty liver disease(NAFLD)and epicardial fat thickness(EAT)in patients with type 2 diabetes mellitus(T2DM).Methods: Ninety-seven patients with T2 DM were enrolled,all the patients in group can fully meet the diagnostic criteria of diabetes established by the WHO in 1999.According to whether NAFLD was combined,it was divided into control group(group A,47 cases)and NAFLD group(50 cases).Group A included 20 males and 27 females,the average age was(54.9±11.1)years old;the NAFLD group included 27 males and 23 females,the average age was(55.2±10.9)years old.Liver ultrasonography were performed in the two groups,using LOGIQ E9 color ultrasonic diagnostic instrument(GE company,USA),the probe frequency is 2.5 ~ 4.0 MHz,all the patients are fasting for more than 8h,supine position,observe the liver size and shape,liver parenchyma echo and intrahepatic tube,According to the two-dimensional ultrasound,the NAFLD group was divided into mild NAFLD group(group B),moderate NAFLD group(group C)and severe NAFLD group(group D).Among them,22 patients in group B,12 males and 10 females,the average age was(56.2±11.4)years old,and 19 patients in group C,including 11 males and 9 females,with an average age of(52.9±11.5)years old,and 9patients with D group,4 males and 5 females the average age was(58.6±8.1)years old.Exclusion criteria: type 1 diabetes mellitus,localized fatty liver,congenital heart disease and severe heart failure,chronic kidney disease,other causes of chronic liver disease,such as parasites,viruses,drug-induced liver damage,and drugs may cause secondary NAFLD.All subjects had no history of alcohol abuse or alcohol consumption <140 g/w(female <70 g/w).There were no significant differences in gender and age between the groups(P>0.05).The LOGIQ VIVID7 color ultrasonic diagnostic instrument(GE Company,USA)was used to measured EAT thickness,the probe frequency was from1.7 to 3.4 MHz.Patients were taken left lateral decubitus,and the long axis section of the sternum was detected.The midline was perpendicular to the right ventricular free wall and the aortic annulus.The hypoechoic regions between myocardial outer layer and the visceral pericardium were measured at the end of ventricular end diastolic phase.The EAT thickness was measured for correlation analysis.At the same time,serum total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),glycated hemoglobin(HbAlc),fasting blood glucose(FBG),and postprandial 2h blood glucose(2hPG),body mass index(BMI),waist circumference and other clinical and biochemical indicators were obtained.Results: The EAT values of group B,C and D were higher than those of group A(all P<0.05).The EAT values of groups C and D were higher than those of group B(all P<0.05).And the EAT values of group D was higher than that of group C(P<0.05).Spearman correlation analysis showed that EAT was positively correlated with NAFLD severity(r=0.782,P<0.001)?HbA1c(r=0.679,P<0.001)?TG(r=0.649,P<0.001)?BMI(r=0.601,P< 0.05)and waist circumference(r = 0.564,P < 0.05),and there is no significant correlation between EAT and FBG?2hBPG?LDL?HDL and TC.HbAlc?TG and BMI were independent predictors of EAT in multiple linear regression analysis.Conclusions: The EAT thickness is thickened in the T2 DM patients with NAFLD.And EAT increases with the severity of NAFLD,there was a positive correlation between them.The abnormal changes of EAT in T2 DM patients with NAFLD can be evaluated by ultrasonography objectively. |
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