Higher cardiovascular risk scores and liver fibrosis risk estimated by biomarkers in patients with metabolic-dysfunction-associated fatty liver disease

Table 1 Clinical and biochemical characteristics of patients with metabolic-dysfunction-associated fatty liver disease and cardiovascular risk estimated by the Framingham system (n = 125)

	Cardiovascular risk1
n (%) / mean ± SD	Mild, n = 46	Moderate, n = 36	High, n = 43	P value
Sex
Female	35 (76.1)	23 (63.9)	21 (48.8)	0.028
Male	11 (23.9)	13 (36.1)	22 (51.2)
Age	50.1 ± 8.1	54.6 ± 7.6	59 ± 8.4	0.0002
BMI (average)	32.5 ± 5.8	32.3 ± 5.9	32.1 ± 4.1	0.964
Normal, n (%)	-	2 (5.6)	1 (2.3)	-
Overweight, n (%)	16 (34.8)	13 (36.1)	12 (27.9)	0.480
Obesity, n (%)	30 (65.2)	21 (58.3)	30 (69.8)
Comorbidities
Smoking, n (%)	10 (21.7)	16 (44.4)	21 (48.8)	0.018
DM, n (%)	-	-	28 (65.1)	0.0002
Hypertension, n (%)	11 (23.9)	16 (44.4)	27 (62.8)	0.0002
SBP	120 ± 12	127 ± 13	131 ± 16	0.0012
Biochemistry
PLQ (x 103/mm3)	249 ± 82	229 ± 60	229 ± 68	0.335
Glucose (mg/dL)	93 ± 14	95 ± 16	147 ± 74	0.0002
TB (mg/dL)	0.62 ± 0.20	0.65 ± 0.26	0.75 ± 0.4	0.126
AST (UI)	34.0 ± 15.4	36.1 ± 13	37.2 ± 20.4	0.660
ALT (UI)	39.7 ± 28.1	37.6 ± 18.6	40.7 ± 35.1	0.888
AP (UI)	82.1 ± 19.2	96.5 ± 33.2	97.7 ± 36.6	0.0302
Albumin (g/dL)	4.0 ± 0.25	4.1 ± 0.32	4.0 ± 0.23	0.626
Insulin	8.9 ± 4.7	8.3 ± 4.3	12.8 ± 9.1	0.0042
HOMA-IR	2.0 ± 1.19	1.9 ± 1.0	4.4 ± 3.5	0.0002
Creatinine (mg/dL)	0.7 ± 0.1	0.9 ± 0.5	0.9 ± 0.3	0.289
Uric acid (mg/dL)	6.0 ± 1.3	5.9 ± 1.6	6.1 ± 1.6	0.813
TC (mg/dL)	205.9 ± 38.2	201.4 ± 36.4	192.5 ± 38.4	0.240
LLD (mg/dL)	114.9 ± 32.7	115.1 ± 27.9	104.3 ± 40.4	0.261
HDL (mg/dL)	52.7 ± 12.5	53.09 ± 18.3	48.6 ± 12.8	0.296
TG (mg/dL)	225.1 ± 332.6	167.6 ± 58.8	197.6 ± 96.6	0.477
Fibrosis markers
FIB-4	1.286 ± 0.772	1.569 ± 0.836	1.851 ± 1.744	0.094
APRI	0.345 ± 0.241	0.376 ± 0.215	0.419 ± 0.419	0.526
NAFLD score	-1.166 ± 1.180	-1.151 ± 1.060	-0.677 ± 1.333	0.110

¹Cardiovascular risk estimated by Framingham system.

²Analysis of variance ANOVA.

BMI: Body mass index; DM: Diabetes mellitus; SBP: Systolic blood pressure; PLQ: Platelets,; TB: Total bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; AP: Alkaline phosphatase; TC: Total cholesterol; LLD: Lipoprotein low-density; HDL: High-density lipoprotein; TG: Triglycerides; FIB-4: Fibrosis-4; APRI: Aspartate aminotransferase-to-platelet ratio index; NAFLD: Nonalcoholic fatty liver disease.

Table 2 Correlation between hepatic steatosis and cardiovascular risk by the Framingham system (n = 69)

	Steatosis (CAP), n (%)
	S0, n = 13	S1, n = 7	S2, n = 3	S3, n = 46	P value
Framingham
Mild (n = 18)	3 (4.3)	2 (2.9)	0	13 (18.8)	0.254
Moderate (n = 24)	5 (7.2)	5 (7.2)	1 (1.4)	13 (18.8)
High (n =27)	5 (7.2)	0	2 (2.9)	20 (28.9)

Degree of steatosis due to controlled attenuation parameter: S0 < 5% of hepatic fatty tissue, S1 between 5% to 33%, S2 between 34% to 66% and S3 > 64%. Cap: controlled attenuation parameter.