Sarcopenic obesity in patients with arterial hypertension and metabolic dysfunction-associated steatotic liver disease: focus on inflammation. Part 1

Purpose. The purpose of the study was to evaluate the nonspecific inflammatory markers in patients with arterial hypertension (AH) and metabolic dysfunction-associated steatotic liver disease (MASLD) depending on the presence of sarcopenic obesity. Materials and methods. The study included 133 patients of both sexes with AH grade I-II and MASLD, divided into two groups depending on the presence/absence of sarcopenic obesity: group 1 (main) – patients with AH, MASLD, and sarcopenic obesity (n = 34, 25.6%), average age 51.8 ± 6.88 years; group 2 (control) – patients with AH, MASLD without sarcopenic obesity (n = 99, 74.4%), average age 46.4 ± 8.13 years. Sarcopenic obesity was diagnosed based on the criteria of the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity. The concentration of inflammatory markers (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)) in the blood serum was assessed by enzyme immunoassay, and high-sensitivity C-reactive protein (hs-CRP) by biochemical analysis. Statistical analysis of the obtained data was performed using the SPSS 27.0 statistical software package (IBM, USA). The obtained data were interpreted as reliable, and differences between the indicators were considered significant at p < 0.05. Results. Patients with sarcopenic obesity had higher hs-CRP values (2.64 (1.37 – 4.18) mg/L vs. 1.76 (0.90–2.87) mg/L, p = 0.033) compared to individuals without obesity. The IL-6 values (2.56 (1.46–3.64) pg/mL vs. 2.07 (1.26 – 3.62) pg/mL, p = 0.142) and TNF-α (1.13 (0.75 – 3.09) pg/mL vs. 0.50 (0.07 – 3.77) pg/mL, p = 0.227) did not differ significantly between the groups. Correlation analysis revealed multiple associations between inflammatory markers, body composition, muscle strength, and function, with the highest degree of association found with hs-CRP levels. Conclusion. The results of the study indicate that the presence of sarcopenic obesity in patients with AH and MASLD is associated with an increased level of hs-CRP in the blood serum. The second part of the article will present data on the influence of inflammation markers and pro-inflammatory cytokines on cardiometabolic risks in patients with sarcopenic obesity, AH, and MASLD, and will describe the mechanisms of increasing the risk of metabolic dysfunction associated with liver steatosis and AH, as a key link in the pathophysiology of comorbidity in this category of patients.