Abstract
IntroductionHepatic steatosis is associated with cardiac systolic and diastolic dysfunction. Therefore, we evaluated metabolites and their potential cardiovascular effects in metabolic-dysfunction-associated fatty liver disease (MAFLD).Materials and methodsWe conducted a cross-sectional study involving 75 participants (38 MAFLD and 37 controls). Hepatic steatosis was confirmed by hepatic ultrasonography and SteatoTestTM. Cardiac function was assessed using echocardiography. Metabolomic analysis was conducted using ultra-high-performance liquid chromatography–mass spectrometry.ResultsThe median age for participants’ age was 45 (IQR 30–56.5), with gender distribution of 35 males and 40 females. MAFLD patients had lower levels of glycyl tyrosine (p-value < 0.001), lysophosphatidylcholine (LPC) (18:2/0:0) (p-value < 0.001), LPC (22:6) (p-value < 0.001), and ceramide (Cer) (d18:0/23:0) (p-value 0.003) compared to controls. MAFLD patients presented lower left ventricular ejection fraction (LVEF), E/A ratio, E/e′ ratio, and average global longitudinal strain (GLS) values, with a p-value of 0.047, <0.001, 0.008, and <0.001, respectively. Decreased glycyl tyrosine levels were significantly correlated with reduced LVEF, even after performing multiple linear regression with 95% CI (1.34–3.394, p-value < 0.001). Moreover, decreased LPC (18:2/0:0) levels remained significantly associated with E/A ratio, even after adjusting for confounding factors with 95% CI (0.008–0.258, p-value = 0.042).ConclusionMAFLD patients are at risk for developing cardiac systolic and subclinical systolic dysfunctions, as well as diastolic dysfunction. Decreased glycyl tyrosine levels correlate with reduced LVEF and LPC (18:2/0:0) levels with diastolic dysfunction, even after adjusting for confounding factors, suggesting their potential to be used as metabolic biomarkers in detecting cardiovascular risk.
Highlights
Hepatic steatosis is associated with cardiac systolic and diastolic dysfunction
Several metabolic biomarkers have been recently studied in hepatic steatosis, including lysophosphatidylcholine (LPC) an endogenous phospholipid from the class glycerophospholipids, glycyl tyrosine a dipeptide composed of glycine and L-tyrosine joined by a peptide linkage, ceramides being considered as members of the class of compounds known as sphingolipids (SPs), and triglycerides being members of glycerolipids [9,10,11,12,13]
The present study demonstrated that metabolic-dysfunction-associated fatty liver disease (MAFLD) patients present with systolic, subclinical systolic, and diastolic dysfunctions
Summary
Hepatic steatosis is associated with cardiac systolic and diastolic dysfunction. We evaluated metabolites and their potential cardiovascular effects in metabolic-dysfunction-associated fatty liver disease (MAFLD). Decreased glycyl tyrosine levels correlate with reduced LVEF and LPC (18:2/0:0) levels with diastolic dysfunction, even after adjusting for confounding factors, suggesting their potential to be used as metabolic biomarkers in detecting cardiovascular risk. Several metabolic biomarkers have been recently studied in hepatic steatosis, including lysophosphatidylcholine (LPC) an endogenous phospholipid from the class glycerophospholipids, glycyl tyrosine a dipeptide composed of glycine and L-tyrosine joined by a peptide linkage, ceramides being considered as members of the class of compounds known as sphingolipids (SPs), and triglycerides being members of glycerolipids [9,10,11,12,13]. Several methods have been described to evaluate cardiac systolic and diastolic functions, as well as subclinical systolic function
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