在患有糖尿病足的患者中,代谢功能障碍相关的脂肪肝疾病和MACCE之间的关联:一项双重纵向队列研究
Xiuxian Huang1, Zhengming Li1, Zhenwei Zhai1
1Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China.
概括
与代谢功能障碍相关的脂肪肝疾病 (MAFLD) 在糖尿病足 (DFU) 患者中显著增加了重大心脏和脑性不良事件 (MACCE) 的风险. 在DFU患者中早期发现和干预MAFLD,特别是那些患有外周动脉疾病 (PAD) 的人,对于改善结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 与代谢功能障碍相关的脂肪肝疾病 (MAFLD) 与代谢障碍有关.
- 糖尿病足 (DFU) 中MAFLD的预后影响尚未得到充分证实.
- DFU与显著的发病率和死亡率有关,通常是由于心血管并发症.
研究的目的:
- 在被诊断为DFU的患者中,调查MAFLD与重大心脏和大脑不良事件 (MACCEs) 风险之间的关联.
- 确定MAFLD是否是DFU人口中心血管和脑血管不良结果的独立风险因素.
主要方法:
- 从2013年到2023年,对889名DFU患者 (PEDIS/TEXAS轻度及以上) 的队列进行了回顾性分析.
- 患者被分为非MAFLD (n=643) 和MAFLD (n=246) 组.
- 使用多变量考克斯回归,分层分析和卡普兰-梅尔生存分析来评估MAFLD和MACCE之间的关联,平均随访时间为63个月.
主要成果:
- 共有214名 (24.07%) 患者经历了MACCEs.
- MAFLD独立地与MACCEs的风险增加有关 (P<0.001),包括非致命的心肌梗塞,非致命性中风,冠状动脉再血管化,心力衰竭和全因死亡率.
- 在外围动脉疾病 (PAD) 亚组中,MAFLD使MACCE的风险增加了2.64倍 (P<0.001).
结论:
- 在患有DFU的患者中,MAFLD被确定为MACCE的重要风险因素.
- 临床医生应优先对DFU患者进行MAFLD查,特别是那些同时患有PAD的患者.
- 针对MAFLD的及时干预策略可以通过减少MACCE来改善DFU患者的临床预后.
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