CARDIORENAL METABOLIC SYNDROME IN PATIENTS WITH CONCOMITANT STEATOTIC LIVER DISEASE
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15498Keywords:
cardiorenal metabolic syndrome, metabolic dysfunction-associated steatotic liver disease, glomerular filtration rate, insulin sensitivity, cardiac structureAbstract
SUMMARY. The manifestations of cardiorenal metabolic syndrome (CRMS) are poorly described in the setting of concomitant metabolic dysfunction-associated steatotic liver disease (MASLD), which is important for postprandial carbohydrate metabolism.
The aim – to evaluate the manifestations of cardiorenal metabolic syndrome in cardiac patients with concomitant MASLD.
Material and Methods. The study included 395 patients with coronary heart disease and arterial hypertension of the 2nd degree, 299 of them had concomitant MASLD of the stages of steatosis S2-3 fibrosis F0-1, they were divided into groups with liver steatosis (LS; n=263) and steatohepatitis (SH; n=36). Normal liver function was in 96 patients. The study was conducted in compliance with the Helsinki Declaration of Human Rights and the orders of the Ministry of Health of Ukraine. An oral glucose tolerance test was performed, and the area under the glucose curve and the McAuley, Matsuda, and De Fronzo insulin sensitivity indices were calculated. Creatinine was determined by the enzymatic method and glomerular filtration rate (GFR) by MDRD. The results were processed statistically with logistic regression analysis.
Results. The frequency of CRMS with a decrease in eGFR <90 among 395 patients was 46.67-56.72 %, regardless of the presence or absence of MASLD and its stage. Cardio-renal connection was manifested by the fact that with increasing creatinine and decreasing GFR, the arterial hypertension, ventricular hypertrophy and dilatation, the systolic dysfunction progressed. The renal metabolic component was characterised by lower glucose level in all measurements of the oral glucose tolerance test with decreased GFR and changes in insulin secretion and tissue insulin sensitivity by indices.
Conclusions. Cardiorhepatic metabolic syndrome in patients with concomitant MASLD was characterised by structural changes in the heart and changes in insulin secretion and insulin sensitivity of tissues with a decrease in glomerular filtration rate.
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