STEATOSIS OF THE LIVER IN PATIENTS WITH STABLE ANGINA
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14303Keywords:
metabolic-associated liver steatosis, coronary artery disease, stable angina, alanine aminotransferase, uric acid, C-reactive proteinAbstract
SUMMARY. Today we know a lot about the association of coronary artery disease (CAD) with non-alcoholic fatty liver disease (NAFLD), which have common pathogenetic mechanisms. However, quite little attention has been paid to the clinical features of the initial stage – liver steatosis (LS).
The aim – to indicate the differences in clinical, laboratory and instrumental parameters in patients with metabolic-associated liver steatosis (MALS) and stable angina (SA).
Material and Methods. 75 patients with coronary artery disease and stable angina (31 men, 44 women, on average aged 44.05 y.o.) were examined and treated in the inpatient hospital. They were divided into 2 groups: with an intact liver (n=19, 5 men and 14 women, aged 39) and with LS (n=56, 26 men, 30 women, aged 49.11 y.o.). Digital data were processed statistically.
Results. The incidence of MALS in patients with SA was 74.8 %, which significantly exceeded the frequency of intact liver (25.2 %, p<0.05). It was associated with the older age of patients (49.11±1.97 vs. 39.00± 3.00 y.o.) and with a higher body weight (body mass index 28.69±0.97 vs. 23.82±1.80 kg/m2), both p<0.05. Also, significantly higher variables of liver-specific alanine aminotransferase, uric acid, and C-reactive protein, right ventricular and left atrial dimensions, and left ventricular conduction disturbances. According to the literary sources, these heart disorders can be explained by accelerated myocardial remodeling due to decreased capture glucose by cardiomyocytes.
Conclusion. Metabolic-associated liver steatosis is related to changes in the metabolic background and heart condition.
References
Chang, Y., Ryu, S., Sung, K. C., Cho, Y. K., & Sung, E. (2019). Alcoholic and non-alcoholic fatty liver disease and associations with coronary artery calcification: evidence from the Kangbuk Samsung Health Study. Gut, 68(9), 1667-1675. DOI: 10.1136/gutjnl-2018-317666. DOI: https://doi.org/10.1136/gutjnl-2018-317666
Brouwers, M.C.G.J., Simons, N., Stehouwer, C.D.A., & Isaacs, A. (2020). Non-alcoholic fatty liver disease and cardiovascular disease: assessing the evidence for causality. Diabetologia, 63(2), 253-260. DOI: 10.1007/s00125-019-05024-3. DOI: https://doi.org/10.1007/s00125-019-05024-3
Wen, W., Li, H., Wang, C., Chen, C., & Tang, J. (2022). Metabolic dysfunction-associated fatty liver disease and cardiovascular disease: A meta-analysis. Front. Endocrinol. (Lausanne), 13, 934225. DOI: 10.3389/fendo.2022.934225. DOI: https://doi.org/10.3389/fendo.2022.934225
Cobbina, E., & Akhlaghi, F. (2017). Non-alcoholic fatty liver disease (NAFLD) – pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab. Rev., 49(2), 197-211. DOI: 10.1080/ 03602532. 2017. 1293683. DOI: https://doi.org/10.1080/03602532.2017.1293683
Khov, N., Sharma, А., & Riley, Т.R. (2014). Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease. World J. Gastroenterol., 20(22), 6821-6825. DOI: 10.3748/wjg.v20.i22.6821. DOI: https://doi.org/10.3748/wjg.v20.i22.6821
Lee, S.B., Park, G.M., & Lee, J.Y. (2018). Association between non-alcoholic fatty liver disease and subclinical coronary atherosclerosis: An observational cohort study. J. Hepatol., 68(5), 1018-1024. DOI: 10.1016/j.jhep.2017.12.012. DOI: https://doi.org/10.1016/j.jhep.2017.12.012
Smith, А.К., Ropella, G.E.P., McGill, M.R., Krishnan, Р., & Dutta, L. (2020). Contrasting model mechanisms of alanine aminotransferase (ALT) release from damaged and necrotic hepatocytes as an example of general biomarker mechanisms. PLoS Comput. Biol., 16(6), e1007622. DOI: 10.1371/journal.pcbi.1007622. DOI: https://doi.org/10.1371/journal.pcbi.1007622
Maloberti, A., Giannattasio, C., & Bombelli, M. (2020). Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project. High Blood Press Cardiovasc. Prev., 27(2), 121-128. DOI: 10.1007/s40292-020-00368. DOI: https://doi.org/10.1007/s40292-020-00368-z
Lee, Y.H., Kim, K.J., Yoo, M.E., Kim, G., & Yoon, H.J. (2018). Association of non-alcoholic steatohepatitis with subclinical myocardial dysfunction in non-cirrhotic patients. J. Hepatol., 68(4), 764-772. DOI: 10.1016/j.jhep. 2017.11.02. DOI: https://doi.org/10.1016/j.jhep.2017.11.023
