Multivariate prognosis of non-alcoholic fatty liver disease development in visceral obesity in patients with coronary artery disease and hypertension

Abstract

Aim . To create a model for non-alcoholic fatty liver disease (NAFLD) development at the steatosis stage in visceral obesity in patients with coronary artery disease (CAD) and hypertension (HTN). Material and methods . The study included male patients with coronary artery disease, stable angina and hypertension: experimental group — 75 patients, control group — 38 patients. All patients underwent an anthropometric assessment, visualization and measurement of the intraabdominal fat thickness (AIFT) and epicardial fat thickness (EFT) by ultrasound, and echocardiography. The liver state was assessed using clinical and functional biochemical tests and ultrasound. Lipid and carbohydrate metabolism parameters was also evaluated. The influence of each of the studied indicators on NAFLD development was determined using the factor and correlation analysis. Results. We created a mathematical model for predicting the NAFLD at the steatosis stage. Using significant variables (body mass index (BMI), EFT, AIFT, left ventricular posterior wall thickness (LVPWT), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) value), a regression model was created. There was following resulting regression equation: prognostic index K= -24,9+0,81 х BMI+1,06 х EFT+0,02 х AIGT+0,6 х LVPWT-1,07 х HOMA-IR. To test the developed model, a double-blind randomized study was performed. At K<9,37, the risk of NAFLD can be regarded as low, at K>15,38 — as high. Values from 9,37 to 15,38 are considered intermediate. Conclusion . During the study, an original model was developed to calculate the likelihood of NAFLD development. The resulting model with the assessment of risk factors in patients with CAN and HTN with visceral obesity can be used to plan a prevention strategy. Patented invention №2718325RU dated 01.04.2020.