Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease

Background Insulin resistance (IR) is the cornerstone of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), pathophysiologically being the key link between MASLD, metabolic disorders, and cardiovascular (CV) diseases. There are no prospective studies comparing the predictive values of...

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Bibliographic Details
Published in:Cardiovascular diabetology Vol. 23; no. 1; pp. 175 - 13
Main Authors: Colantoni, Alessandra, Bucci, Tommaso, Cocomello, Nicholas, Angelico, Francesco, Ettorre, Evaristo, Pastori, Daniele, Lip, Gregory Y.H., Del Ben, Maria, Baratta, Francesco
Format: Journal Article
Language:English
Published: London BioMed Central 20.05.2024
Springer Nature B.V
BMC
Subjects:
Adipose tissue
Adult
Aged
Angiology
Biomarkers - blood
Blood glucose
Blood Glucose - metabolism
Cardiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cardiovascular events
Cholesterol
Diabetes
Disease resistance
Female
Health risks
Heart attacks
Heart Disease Risk Factors
High density lipoprotein
Homeostasis
Humans
Hypertension
Insulin - blood
Insulin Resistance
Ischemia
Lipid Accumulation Product
Lipids
Liver diseases
Male
MASLD
Medicine
Medicine & Public Health
Metabolic disorders
Metabolic syndrome
Middle Aged
Non-alcoholic Fatty Liver Disease - blood
Non-alcoholic Fatty Liver Disease - complications
Non-alcoholic Fatty Liver Disease - diagnosis
Obesity
Pathophysiology
Predictive Value of Tests
Prognosis
Prospective Studies
Regression analysis
Risk Assessment
Risk Factors
Software
Stroke
Time Factors
Triglycerides
Triglycerides - blood
TyG index
Womens health
Cardiovascular events
Insulin resistance
MASLD
TyG index
ISSN:1475-2840, 1475-2840
Online Access:Get full text
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Summary:Background Insulin resistance (IR) is the cornerstone of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), pathophysiologically being the key link between MASLD, metabolic disorders, and cardiovascular (CV) diseases. There are no prospective studies comparing the predictive values of different markers of insulin resistance (IR) in identifying the presence of MASLD and the associated risk of cardiovascular events (CVEs). Methods Post hoc analysis of the prospective Plinio Study, involving dysmetabolic patients evaluated for the presence of MASLD. The IR markers considered were Homeostatic Model Assessment for IR (HOMA-IR), Triglycerides-Glycemia (TyG) index, Triglycerides to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). Receiver operative characteristic (ROC) analyses were performed to find the optimal cut-offs of each IR marker for detecting MASLD and predicting CVEs in MASLD patients. Logistic and Cox multivariable regression analyses were performed, after dichotomizing the IR markers based on the optimal cut-offs, to assess the factors independently associated with MASLD and the risk of CVEs. Results The study included 772 patients (age 55.6 ± 12.1 years, 39.4% women), of whom 82.8% had MASLD. VAI (Area Under the Curve [AUC] 0.731), TyG Index (AUC 0.723), and TG/HDL-C ratio (AUC: 0.721) predicted MASLD but was greater with HOMA-IR (AUC: 0.792) and LAP (AUC: 0.787). After a median follow-up of 48.7 (25.4–75.8) months, 53 MASLD patients experienced CVEs (1.8%/year). TyG index (AUC: 0.630), LAP (AUC: 0.626), TG/HDL-C (AUC: 0.614), and VAI (AUC: 0.590) demonstrated comparable, modest predictive values in assessing the CVEs risk in MASLD patients. Conclusion In dysmetabolic patients HOMA-IR and LAP showed the best accuracy in detecting MASLD. The possible use of lipid-based IR markers in stratifying the CV risk in patients with MASLD needs further validation in larger cohorts.
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ISSN:1475-2840
1475-2840
DOI:10.1186/s12933-024-02263-6