Obesity as a predictor of atherogenic dyslipidemia in patients with metabolic dysfunction associated steatotic liver disease

Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at high risk of atherogenic dyslipidemia and cardiovascular events, which are considered the most important cause of death in these patients. The aim of this study was to investigate the association between atherogenic indices with adiposity and to compare the atherogenic status between obese and non-obese MASLD patients. In this cross-sectional study, 452 participants with Fibroscan-proven MASLD were included. Atherogenic indices, insulin resistance and sensitivity indicators were calculated for all patients. Atherogenic risk of participants were compared based on their body mass index (BMI). Pearson correlation analysis and linear regression were applied to analyze the relationship between BMI and cardiovascular risk factors. Atherogenic indices were higher in overweight and obese MASLD patients than non-obese ones. Insulin resistance progressively increased in proportion to the BMI, while insulin sensitivity decreased (P < 0.001). Obesity, but not overweight, was associated with a significant increase in atherogenic indices in patients (P < 0.05). BMI was positively correlated with insulin resistance indicators (P < 0.001), triglyceride glucose index (r = 0.121, P = 0.010) and atherogenic index of plasma (r = 0.096, P = 0.042). It can be concluded that obesity, by exacerbating insulin resistance and atherogenic status, predispose patients with MASLD to an increased risk of developing cardiovascular diseases.