Correlation analysis between non-alcoholic fatty liver disease and severity of coronary artery stenosis in patients with coronary heart disease

doi:10.11958/20260303

Abstract

Abstract:

Objective To investigate the effect of non-alcoholic fatty liver disease (NAFLD) on the severity of coronary artery stenosis in patients with coronary heart disease (CHD), and to analyze the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) and inflammatory factors in it. Methods A total of 537 CHD inpatients diagnosed by coronary angiography at Tianjin Nankai Hospital from September 2015 to September 2025 were enrolled. Based on abdominal ultrasound or CT findings, they were divided into the non-NAFLD group, the mild NAFLD group and the moderate-to-severe NAFLD group. Serum biochemical parameters, levels of PCSK9, interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) were measured. The Gensini score was used to assess the severity of coronary artery stenosis. The correlations between NAFLD and the severity of coronary stenosis as well as various indicators were analyzed. Results The Gensini scores of the non-NAFLD group, the mild NAFLD group and the moderate-to-severe NAFLD group increased successively (P<0.05). Serum levels of total protein (TP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), creatine kinase (CK), CK-MB, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), PCSK9, IL-1β, IL-6 and TNF-α increased sequentially in the non-NAFLD group, the mild NAFLD group and the moderate-to-severe NAFLD group, while levels of albumin (ALB) and high-density lipoprotein cholesterol (HDL-C) decreased sequentially (all P<0.05). Spearman correlation analysis revealed that the severity of NAFLD was positively correlated with TP, ALT, AST, GGT, LDH, TC, TG, LDL-C, PCSK9, IL-1β, IL-6, TNF-α levels and Gensini score, and negatively correlated with ALB and HDL-C levels (all P<0.05). Pearson correlation analysis showed that Gensini score was positively correlated with TP, ALT, AST, GGT, LDH, TC, TG, LDL-C, PCSK9, IL-1β, IL-6 and TNF-α levels, and negatively correlated with ALB (all P<0.05). PCSK9 was also positively correlated with IL-1β, IL-6 and TNF-α levels (all P<0.05). Conclusion NAFLD is positively correlated with the severity of coronary artery stenosis in CHD patients, and the underlying mechanism may be related to the elevated PCSK9 levels, inflammatory response and lipid metabolism disorders.

Key words: non-alcoholic fatty liver disease, coronary heart disease, coronary stenosis, proprotein convertase subtilisin/kexin type 9, cytokines, lipid metabolism disorders

CLC Number:

R541.4，R575.5

Figures/Tables 3

References 12

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组别	n		年龄/ 岁		性别（男/女）	BMI/ （kg/m²）
非NAFLD组	219		65.63±10.26		117/102	25.2±3.6
轻度NAFLD组	196		64.92±9.36		105/91	25.4±3.8
中重度NAFLD组	122		65.32±9.36		79/43	25.6±3.9
F或χ²			0.220		1.485	0.460
组别		糖尿病		高血压			高脂血症
非NAFLD组		23（10.50）		35（15.98）			18（8.22）
轻度NAFLD组		18（9.18）		29（14.80）			14（7.14）
中重度NAFLD组		13（10.66）		17（13.93）			12（9.84）
F或χ²		0.238		0.274			0.746

组别	n		年龄/ 岁		性别（男/女）	BMI/ （kg/m²）
非NAFLD组	219		65.63±10.26		117/102	25.2±3.6
轻度NAFLD组	196		64.92±9.36		105/91	25.4±3.8
中重度NAFLD组	122		65.32±9.36		79/43	25.6±3.9
F或χ²			0.220		1.485	0.460
组别		糖尿病		高血压			高脂血症
非NAFLD组		23（10.50）		35（15.98）			18（8.22）
轻度NAFLD组		18（9.18）		29（14.80）			14（7.14）
中重度NAFLD组		13（10.66）		17（13.93）			12（9.84）
F或χ²		0.238		0.274			0.746

组别	n			TP/（g/L）			ALB/（g/L）			ALT/（U/L）
非NAFLD组	219			73.61±15.29			45.28±5.76			31.70±6.54
轻度NAFLD组	196			76.30±20.10^a			43.20±5.80^a			87.98±23.64^a
中重度NAFLD组	122			80.50±22.30^ab			40.10±4.90^ab			110.31±31.99^ab
F				6.045^＊			34.872^＊			474.198^＊
组别			AST/（U/L）			GGT/（U/L）			LDH/（U/L）
非NAFLD组			38.95±7.82			12.35±3.41			170.34±36.58
轻度NAFLD组			76.31±11.78^a			57.32±12.69^a			263.94±45.20^a
中重度NAFLD组			97.03±22.47^ab			69.28±17.41^ab			285.61±75.53^ab
F			580.221^＊			892.441^＊			199.336^＊
组别			CK/（U/L）			CK-MB/（U/L）			TC/（mmol/L）
非NAFLD组			257.62±57.91			74.62±15.59			5.34±1.04
轻度NAFLD组			289.97±75.53^a			119.57±25.91^a			6.54±2.61^a
中重度NAFLD组			331.90±81.04^ab			131.39±31.05^ab			7.83±2.10^ab
F			37.426^＊			204.570^＊			43.511^＊
组别		TG/（mmol/L）			HDL-C/（mmol/L）			LDL-C/（mmol/L）
非NAFLD组		1.59±0.84			1.72±0.69			4.37±1.23
轻度NAFLD组		3.72±1.72^a			1.57±0.68^a			5.25±1.74^a
中重度NAFLD组		4.74±0.93^ab			1.39±0.35^ab			6.58±1.03^ab
F		198.739^＊			10.112^＊			49.380^＊

组别	n			TP/（g/L）			ALB/（g/L）			ALT/（U/L）
非NAFLD组	219			73.61±15.29			45.28±5.76			31.70±6.54
轻度NAFLD组	196			76.30±20.10^a			43.20±5.80^a			87.98±23.64^a
中重度NAFLD组	122			80.50±22.30^ab			40.10±4.90^ab			110.31±31.99^ab
F				6.045^＊			34.872^＊			474.198^＊
组别			AST/（U/L）			GGT/（U/L）			LDH/（U/L）
非NAFLD组			38.95±7.82			12.35±3.41			170.34±36.58
轻度NAFLD组			76.31±11.78^a			57.32±12.69^a			263.94±45.20^a
中重度NAFLD组			97.03±22.47^ab			69.28±17.41^ab			285.61±75.53^ab
F			580.221^＊			892.441^＊			199.336^＊
组别			CK/（U/L）			CK-MB/（U/L）			TC/（mmol/L）
非NAFLD组			257.62±57.91			74.62±15.59			5.34±1.04
轻度NAFLD组			289.97±75.53^a			119.57±25.91^a			6.54±2.61^a
中重度NAFLD组			331.90±81.04^ab			131.39±31.05^ab			7.83±2.10^ab
F			37.426^＊			204.570^＊			43.511^＊
组别		TG/（mmol/L）			HDL-C/（mmol/L）			LDL-C/（mmol/L）
非NAFLD组		1.59±0.84			1.72±0.69			4.37±1.23
轻度NAFLD组		3.72±1.72^a			1.57±0.68^a			5.25±1.74^a
中重度NAFLD组		4.74±0.93^ab			1.39±0.35^ab			6.58±1.03^ab
F		198.739^＊			10.112^＊			49.380^＊

组别		n	PCSK9/（μg/L）		IL-1β/（ng/L）
非NAFLD组		219	307.19±35.42		10.45±2.48
轻度NAFLD组		196	318.52±38.67^a		11.58±2.53^a
中重度NAFLD组		122	352.14±47.83^ab		13.31±2.96^ab
F			49.632^＊		42.157^＊
组别	IL-6/（ng/L）			TNF-α/（ng/L）
非NAFLD组	50.78±4.49			5.14±0.40
轻度NAFLD组	58.34±5.12^a			5.38±0.41^a
中重度NAFLD组	70.42±6.28^ab			5.87±0.49^ab
F	410.892^＊			84.507^＊