ASSOCIATION OF FATTY LIVER DISEASE AND ASYMPTOMATIC CAROTID ATHEROSCLEROSIS IN INDIVIDUALS WITH HYPERTENSION AND METABOLIC SYNDROME

Objective: To determine the prevalence of MAFLD in subjects with MetSy and hypertension and its association with asymptomatic carotid atherosclerosis. Design and method: The study included 130 subjects of both genders, with an average age of 52.2±8.2 years, without manifest cardiovascular diseases. The clinical group consisted of subjects with MetSy (n=65), the control group (CG) included subjects without MetSy (n=65). For the diagnosis of MetSy, NCEP ATP III criteria were used. All subjects were analyzed for the presence of cardiovascular risk factors, components of MetSy, anthropometric measurements, and laboratory analyses. Non-invasive assessment of the presence of fatty liver disease was conducted using recommended scores and indices (Fatty Liver Index-FLI, NAFLD Fibrosis Score, APRI). Color Doppler imaging of the carotid arteries was performed on all subjects. Intraluminal lesions were determined using the B-mode imaging and defined as intima-media complex (IMC) thickenings and plaques with focal intimal thickenings. Results: In the MetSy group 75.4% of subjects had hypertension. In these individuals, compared to the CG, the FLI values were significantly higher, defining the presence of fatty liver. In 44 (89.79%) subjects with MetSy and hypertension the presence of fatty liver was determined compared to 12 (18.46%) in the CG (p<0.0001). Regression analysis of factors associated with the development of fatty liver showed a significant link with hypertension and the waist/hip ratio. This link was particularly pronounced in the group of patients with the highest waist/hip ratio (0.98-1.16), p<0.01. Among the biochemical analyses, a significant association with remnant cholesterol was observed. Univariate regression analysis showed that the thickness of IMC and the presence of carotid plaques were associated with the presence MAFLD (p<0.001). It was found that the FLI was significantly higher in patients with proven asymptomatic carotid atherosclerosis compared to subjects without plaques (p<0.001). Conclusions: In subjects with hypertension and MetSy, the presence of MAFLD is significantly more frequent compared to the CG. A significant association was found between MAFLD and hypertension, waist/hip ratio and remnant cholesterol. The thickness of the intima-media complex and the presence of carotid plaques are significantly associated with the presence of MAFLD.