BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),particularly in the presence of liver fibrosis,increases the risk of cardiovascular morbidity and mortality,but the nature of the cardio-hepat...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),particularly in the presence of liver fibrosis,increases the risk of cardiovascular morbidity and mortality,but the nature of the cardio-hepatic interaction in the context type 2 diabetes mellitus(T2DM)is not fully understood.AIM To evaluate the changes in cardiac morphology and function in patients with T2DM and MASLD-associated liver fibrosis.METHODS T2DM patients with MASLD underwent a medical evaluation that included an assessment of lifestyle,anthropometric measurements,vital signs,an extensive laboratory panel,and a standard echocardiography.Liver fibrosis was evaluated using two scores[Fibrosis-4(FIB4)and Non-alcoholic fatty liver disease-Fibrosis Score(NFS)],and subjects were classified as having advanced fibrosis,no fibrosis,or an indeterminate risk.The correlations between structural and functional cardiac parameters and markers of liver fibrosis were evaluated through bivariate and multiple regression analyses.Statistical significance was set at P<0.05.RESULTS Data from 267 T2DM-MASLD subjects with complete assessment was analyzed.Patients with scores indicating advanced fibrosis exhibited higher interventricular septum and left ventricular(LV)posterior wall thickness,atrial diameters,LV end-systolic volume,LV mass index(LVMi),and epicardial adipose tissue thickness(EATT).Their mean ejection fraction(EF)was significantly lower(49.19%±5.62%vs 50.87%±5.14%vs 52.00%±3.25%;P=0.003),and a smaller proportion had an EF≥50%(49.40%vs 68.90%vs 84.21%;P=0.0017).Their total and mid LV wall motion score indexes were higher(P<0.05).Additionally,they had markers of diastolic dysfunction,with a higher E/e’ratio[9.64±4.10 vs 8.44(2.43-26.33)vs 7.35±2.62;P=0.026],and over 70%had lateral e’values<10 cm/second,though without significant differences between groups.In multiple regression analyses,FIB4 correlated with left atrium diameter(LAD;β=0.044;P<0.05),and NFS with both LAD(β=0.039;P<0.05)and right atrium diameter(β=0.041;P<0.01),Moreover,LVMi correlated positively with age and EATT(β=1.997;P=0.0008),and negatively with serum sex-hormone binding protein(SHBP)concentrations(β=-0.280;P=0.004).SHBP also correlated negatively with LAD(β=-0.036;P<0.05).CONCLUSION T2DM patients with markers of MASLD-related liver fibrosis exhibit lower EF and present indicators of diastolic dysfunction and cardiac hypertrophy.Additionally,LVMi and LAD correlated negatively with serum SHBP concentrations.展开更多
Object:Corona virus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which leads to acute respiratory infection symptoms.SARS-CoV-2 infection is not always limited to the ...Object:Corona virus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which leads to acute respiratory infection symptoms.SARS-CoV-2 infection is not always limited to the respiratory tract,and renal infection and dysfunction have been shown to be specific risk factors for death.In addition,COVID-19 has a higher incidence,severity and mortality in men than women.This disparity is due to biological rather than comorbid or behavioral sex differences.Because the male reproductive system is unique,the function of sex hormones in COVID-19 infection may explain the differences between males and females.Understanding these factors will provide appropriate prevention measures and adequate triage strategies and guide the drug discovery process.Methods:An electronic search was completed in PubMed,ARXIV,MEDRXIV and BIORXIV.The most relevant articles were systematically reviewed.In addition,single cell RNA sequencing analysis of tissue samples from human cell landscape was conducted.Results:The influence of SARS-CoV-2 on the urogenital system,the possibility of urinary tract transmission and the functions of sex hormones were discussed in this review.Conclusion:Corona viruses can invade the genitourinary system,causing urological symptoms.Identifying the potential genitourinary organ impairments and protecting them from damage are necessary.Since sex hormones have potential as specific drugs,the gonadal hormones substitution therapy should be considered in both sexes in the COVID-19 pandemic.展开更多
基金Supported by the University of Medicine,Pharmacy,Science and Technology“George Emil Palade”of Târgu MureșResearch Grant,No.10126/5/17.12.2020.
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),particularly in the presence of liver fibrosis,increases the risk of cardiovascular morbidity and mortality,but the nature of the cardio-hepatic interaction in the context type 2 diabetes mellitus(T2DM)is not fully understood.AIM To evaluate the changes in cardiac morphology and function in patients with T2DM and MASLD-associated liver fibrosis.METHODS T2DM patients with MASLD underwent a medical evaluation that included an assessment of lifestyle,anthropometric measurements,vital signs,an extensive laboratory panel,and a standard echocardiography.Liver fibrosis was evaluated using two scores[Fibrosis-4(FIB4)and Non-alcoholic fatty liver disease-Fibrosis Score(NFS)],and subjects were classified as having advanced fibrosis,no fibrosis,or an indeterminate risk.The correlations between structural and functional cardiac parameters and markers of liver fibrosis were evaluated through bivariate and multiple regression analyses.Statistical significance was set at P<0.05.RESULTS Data from 267 T2DM-MASLD subjects with complete assessment was analyzed.Patients with scores indicating advanced fibrosis exhibited higher interventricular septum and left ventricular(LV)posterior wall thickness,atrial diameters,LV end-systolic volume,LV mass index(LVMi),and epicardial adipose tissue thickness(EATT).Their mean ejection fraction(EF)was significantly lower(49.19%±5.62%vs 50.87%±5.14%vs 52.00%±3.25%;P=0.003),and a smaller proportion had an EF≥50%(49.40%vs 68.90%vs 84.21%;P=0.0017).Their total and mid LV wall motion score indexes were higher(P<0.05).Additionally,they had markers of diastolic dysfunction,with a higher E/e’ratio[9.64±4.10 vs 8.44(2.43-26.33)vs 7.35±2.62;P=0.026],and over 70%had lateral e’values<10 cm/second,though without significant differences between groups.In multiple regression analyses,FIB4 correlated with left atrium diameter(LAD;β=0.044;P<0.05),and NFS with both LAD(β=0.039;P<0.05)and right atrium diameter(β=0.041;P<0.01),Moreover,LVMi correlated positively with age and EATT(β=1.997;P=0.0008),and negatively with serum sex-hormone binding protein(SHBP)concentrations(β=-0.280;P=0.004).SHBP also correlated negatively with LAD(β=-0.036;P<0.05).CONCLUSION T2DM patients with markers of MASLD-related liver fibrosis exhibit lower EF and present indicators of diastolic dysfunction and cardiac hypertrophy.Additionally,LVMi and LAD correlated negatively with serum SHBP concentrations.
文摘Object:Corona virus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which leads to acute respiratory infection symptoms.SARS-CoV-2 infection is not always limited to the respiratory tract,and renal infection and dysfunction have been shown to be specific risk factors for death.In addition,COVID-19 has a higher incidence,severity and mortality in men than women.This disparity is due to biological rather than comorbid or behavioral sex differences.Because the male reproductive system is unique,the function of sex hormones in COVID-19 infection may explain the differences between males and females.Understanding these factors will provide appropriate prevention measures and adequate triage strategies and guide the drug discovery process.Methods:An electronic search was completed in PubMed,ARXIV,MEDRXIV and BIORXIV.The most relevant articles were systematically reviewed.In addition,single cell RNA sequencing analysis of tissue samples from human cell landscape was conducted.Results:The influence of SARS-CoV-2 on the urogenital system,the possibility of urinary tract transmission and the functions of sex hormones were discussed in this review.Conclusion:Corona viruses can invade the genitourinary system,causing urological symptoms.Identifying the potential genitourinary organ impairments and protecting them from damage are necessary.Since sex hormones have potential as specific drugs,the gonadal hormones substitution therapy should be considered in both sexes in the COVID-19 pandemic.
