AI Summary & Key Takeaways
AI InsightFGF-23 levels, on the other hand, can guide clinicians in determining both the severity of renal failure and heart disease.
📌 3 Key Takeaways
Abstract
Aims: Increasing evidence suggests that cardiovascular disease risk increases in metabolic dysfunction-associated steatotic liver disease (MASLD). Fetuin-A, reseptor for advanced glycation end-products (RAGE) and fibroblast growth factor 23 (FGF-23) are associated with insulin resistance (IR), inflammation, oxidative stress, and so predispose to coronary heart disease (CHD). We aimed to investigate the clinical utility of Fetuin-A, RAGE and FGF-23 in assessing CHD risk evaluated by Framingham risk score (FRS) in patients with MASLD. Methods: The study included 80 individuals aged 34-82 years who met the diagnostic criteria for MASLD, and a control group of 60 individuals with normal liver echogenicity on ultrasonography and FRS values less than 10% in cardiac risk assessment. Patients in the MASLD group were further divided into two subgroups: low cardiac risk (FRS <10%) and moderate/high cardiac risk (FRS ≥10%). In addition to routine tests, HOMA-IR, Fetuin-A, RAGE, and FGF-23 levels were also measured. Risk scoring systems related to the prognosis of fatty liver disease, including the AST/platelet ratio index (APRI); fibrosis score (FIB4); fatty liver fibrosis score (NFS); and fatty liver index (FLI), were also calculated. Results: In MASLD patients, anthropometric measurements such as BMI, WC, SBP and DBP; and hematocrit, WBC, AST, ALT, GGT, AP, total cholesterol, TG, LDL-C, fasting insulin, glucose, RAGE, and FGF-23 levels were significantly higher; while HDL-C, albumin, and Fetuin-A levels were lower. Any significance was between the groups in terms of mean age, gender, platelet count, total bilirubin, and direct bilirubin levels. FRS and HOMA-IR levels were also significantly higher in the MASLD group (p<0.001). In MASLD patients with moderate/high probability cardiovascular risk; BMI, PLT, hematocrit, AST, ALT, ALP, GGT, TG, LDL-C, FGF-23, RAGE, FIB-4, and FLI levels tended to be higher; albumin, PLT, and Fetuin-A levels were lower (P<0.05). Any increase in CHD severity was detected with respect to fatty liver severity. Conclusion: In the MASLD group, as cardiac risk increased, RAGE and FGF-23 levels rose significantly, while Fetuin A levels decreased. Any association was found between APRI and NFS scores and cardiac risk; however, FLI and FIB-4 scores were associated with cardiac risk. In particular, higher FGF-23 levels were found to be associated with more parameters. Therefore, non-invasive fibrosis markers, especially FLI and FIB-4 scores, can be used clinically in the follow-up of fatty liver disease patients. FGF-23 levels, on the other hand, can guide clinicians in determining both the severity of renal failure and heart disease.