Investigation of the relationship between carotid intima-media thickness and angiopoietin-like factor 3 levels in metabolic dysfunction-associated steatotic liver disease

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a common condition characterized by excessive fat accumulation in the liver and is closely associated with metabolic syndrome (MetS) and insulin resistance. This study aimed to evaluate the relationship between carotid intima-media thickness (CIMT), a marker associated with cardiovascular risk, and circulating levels of angiopoietin-like protein 3 (ANGPTL3) in patients with MAFLD. The study included 88 patients diagnosed with MAFLD and 88 age- and sex-matched healthy controls who visited the internal medicine clinic between August and November 2022. Data on patient characteristics, laboratory values, and associated diseases were taken from the hospital database. Serum ANGPTL3 levels were measured using venous blood samples, and results with p < 0.05 were considered significant. Serum ANGPTL3 levels and CIMT were significantly higher in the MAFLD patient group compared to controls. ROC analysis showed that a hepatic steatosis index > 33.18 predicted MAFLD with 97.8% sensitivity and 83.33% specificity; ANGPTL3 levels > 242 predicted MAFLD with 51.11% sensitivity and 83.33% specificity; and CIMT > 6 (expressed in 0.1 mm units) predicted MAFLD with 83.33% sensitivity and 91.11% specificity. Our study demonstrated increased serum ANGPTL3 levels in patients with MAFLD. Dyslipidemia observed in MAFLD may be mediated through this hepatokine, suggesting that ANGPTL3 could serve as a non-invasive biomarker for MAFLD diagnosis. Furthermore, serum ANGPTL3 may have potential as a biomarker for liver fibrosis assessment in future studies.