Association of NAFLD fibrosis score with subclinical myocardial remodeling in patients with type 2 diabetes: a cross-sectional study in China.

BACKGROUND Nonalcoholic fatty liver disease (NAFLD), especially with liver fibrosis, is associated with cardiovascular diseases (CVD). NAFLD fibrosis score (NFS), a noninvasive marker of advanced fibrosis， has found to be associated with CVD in different populations. The aim of the present study was to determine whether NFS is associated with subclinical myocardial remodeling in type 2 diabetic patients. METHODS A cross-sectional study was performed in type 2 diabetic patients. NFS derived from available parameters was calculated and the subjects were divided according to the quartiles of NFS and grades of NFS (low, intermediate and high). FIB-4 and APRI, another two liver fibrosis scores, were also calculated. Subclinical myocardial remodeling was examined by echocardiography and its associations with NFS, FIB-4 and APRI were analyzed. RESULTS A total of 1878 type 2 diabetic patients were enrolled in the present study. NFS was independently associated with sex, age, BMI, LDL-C and HbA1c in type 2 diabetic patients. Parameters of subclinical myocardial remodeling including left atrial dimension (LAD), interventricular septum thickness (IST), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT) and left ventricular mass index (LVMI) were all gradually increased with the increment of NFS. Linear regression analysis further revealed that NFS was positively associated with LAD, IST, LVEDD, LVESD, LVPWT and LVMI after adjustment for the confounding factors. Similarly, FIB-4 was associated with LAD, IST, LVPWT and LVMI. In contrast, APRI was only associated with LVPWT. CONCLUSIONS Noninvasive liver fibrosis scores, especially NFS, are independently associated with subclinical myocardial remodeling in type 2 diabetic subjects.