Multivariate prognosis of non-alcoholic fatty liver disease development in visceral obesity in patients with coronary artery disease and hypertension
https://doi.org/10.15829/1560-4071-2021-4015
Abstract
Aim. To create a model for non-alcoholic fatty liver disease (NAFLD) development at the steatosis stage in visceral obesity in patients with coronary artery disease (CAD) and hypertension (HTN).
Material and methods. The study included male patients with coronary artery disease, stable angina and hypertension: experimental group — 75 patients, control group — 38 patients. All patients underwent an anthropometric assessment, visualization and measurement of the intraabdominal fat thickness (AIFT) and epicardial fat thickness (EFT) by ultrasound, and echocardiography. The liver state was assessed using clinical and functional biochemical tests and ultrasound. Lipid and carbohydrate metabolism parameters was also evaluated. The influence of each of the studied indicators on NAFLD development was determined using the factor and correlation analysis.
Results. We created a mathematical model for predicting the NAFLD at the steatosis stage. Using significant variables (body mass index (BMI), EFT, AIFT, left ventricular posterior wall thickness (LVPWT), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) value), a regression model was created. There was following resulting regression equation: prognostic index K= -24,9+0,81 хBMI+1,06хEFT+0,02хAIGT+0,6хLVPWT-1,07хHOMA-IR. To test the developed model, a double-blind randomized study was performed. At K<9,37, the risk of NAFLD can be regarded as low, at K>15,38 — as high. Values from 9,37 to 15,38 are considered intermediate.
Conclusion. During the study, an original model was developed to calculate the likelihood of NAFLD development. The resulting model with the assessment of risk factors in patients with CAN and HTN with visceral obesity can be used to plan a prevention strategy. Patented invention №2718325RU dated 01.04.2020.
About the Authors
I. V. LogachevaRussian Federation
Competing Interests: нет
T. A. Ryazanova
Russian Federation
Competing Interests: not
S. B. Ponomarev
Russian Federation
Competing Interests: not
V. R. Makarova
Russian Federation
Izhevsk
Competing Interests: not
References
1. Shlyakhto EV, Zvartau NE, Villevalde SV, et al. Cardiovascular risk management system: prerequisites for developing, organization principles, target groups. Russian Journal of Cardiology. 2019;24(11):69-82. (In Russ.) doi:10.15829/1560-4071-2019-11-69-82.
2. Boytsov SA, Pogosova NV, Bubnova MG, et al. Cardiovascular prevention 2017. National guidelines. Russ J Cardiol. 2018;23(6):7-122. (In Russ.) doi:10.15829/1560-4071-2018-6-7-122.
3. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4-11. (In Russ.) doi:10.15829/1728-8800-2014-6-4-11.
4. Chumakova GA, Kuznetsova TY, Druzhilov МА, Veselovskaya NG. Visceral adiposity as a global factor of cardiovascular risk. Russian Journal of Cardiology. 2018;23(5):7-14. (In Russ.) doi:10.15829/1560-4071-2018-5-7-14.
5. Sletten AC, Peterson LR, Schaffer JE. Manifestations and mechanisms of myocardial lipotoxicity in obesity. J Intern Med. 2018;284(5):478-91. doi:10.1111/joim.12728.
6. Shlyakhto EV, Nedogoda SV, Konradi AO, et al. The concept of novel national clinical guidelines on obesity. Russian Journal of Cardiology. 2016;4:7-13. (In Russ.) doi:10.15829/1560-4071-2016-4-7-13.
7. Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Diagnostics and treatment of nonalcoholic fatty liver disease: clinical guidelines of the Russian Scientific Liver Society and the Russian gastroenterological association. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(2):24-42. (In Russ.) doi:10.22416/1382-4376-2016-26-2-24-42.
8. Maevskaya MV, Ivashkin VT, Ivashkin KV, et al. Non-alcoholic fatty liver disease as a cause and consequence of cardio-metabolic complications. Role of the ursodeoxicholic acid in the pharmacotherapy. Therapeutic Archive. 2019;91(2):109-17. (In Russ.) doi: 10.26442/00403660.2019.02.000122.
9. Targher G, Byrne CD, Lonardo A, et al. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A metaanalysis. J Hepatol. 2016;65:589-600. doi:10.1016/j.jhep.2016.05.013.
10. Baktir AO, Sarl B, Altekin RE, et al. Nonalcoholic steatohepatitis is associated with subclinical impairment in left ventricular function measured by speckle tracking echocardiography. Anatol J Cardiol. 2015;15(15):137-42. doi:10.5152/akd.2014.5212.
11. Sebastiani G, Alshaalan R, Wong P, et al. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease. World J Gastroenterol. 2015;21(22):6820-34. doi:10.3748/wjg.v21.i22.6820.
12. Logacheva IV, Ryazanova TA, Makarova VR, Surnina OV. Non-Alcoholic Fatty Liver Disease in Cardiac Patients with Overweight and Obesity. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(6):27-37. (In Russ.) doi:10.22416/1382-4376-2018-28-6-27-37.
13. Drapkina OM, Yafarova AA. Non-alcoholic fatty liver disease and cardiovascular risk: scientific problem state. Rational Pharmacotherapy in Cardiology. 2017;13(5):645-50. (In Russ.) doi:10.20996/1819-6446-2017-13-5-645-650.
14. Denisov NL, Grinevich VB, Chernetsova YV, et al. The role of non-alcoholic fatty liver disease in the formation of atherosclerotic vascular lesions in patients with abdominal obesity. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(1):62-71. (In Russ.) doi:10.22416/1382-4376-2017-27-1-62-71.
Supplementary files
Review
For citations:
Logacheva I.V., Ryazanova T.A., Ponomarev S.B., Makarova V.R. Multivariate prognosis of non-alcoholic fatty liver disease development in visceral obesity in patients with coronary artery disease and hypertension. Russian Journal of Cardiology. 2021;26(1):4015. (In Russ.) https://doi.org/10.15829/1560-4071-2021-4015