Non-Alcoholic Fatty Liver Disease and Echocardiographic Parameters in Young Adults With Cardiometabolic Risk Factors

Introduction. Non-alcoholic fatty liver disease, the most common chronic liver disease worldwide, may alter cardiac structure and function regardless of obesity, resulting in heart failure. Therefore, the association of changes in liver steatosis indices, as integral indicators of dysmetabolic processes, with changes in echocardiographic parameters is of interest. Aim. To study echocardiographic features in nonalcoholic fatty liver disease and the relationship between hepatic steatosis indices and cardiac structural and functional parameters. Materials and Methods. This “case-control” study performed in Kazan included 142 patients (74 males and 68 females) aged 35 [31-39] years. A full clinical examination was performed, including anthropometry, laboratory work-up, liver ultrasonography, and echocardiography. Non-alcoholic fatty liver disease–liver fat score, hepatic steatosis, and triglyceride and glucose indices were calculated. Data were processed using IBM SPSS Statistics 26. Results and Discussion. Ultrasonography revealed non-alcoholic fatty liver disease in 10.2% of individuals. Increased liver steatosis indices were observed in 64.8% of subjects. We found a simultaneous increase in two indices in 40.3%, and in all three indices in 14% of cases. In patients with non-alcoholic fatty liver disease, in contrast to obese subjects, we observed higher left ventricular myocardial mass (p=0.013), left atrial volume (p=0.033), end-diastolic dimension (p=0.016), end-systolic volume (p=0.022), and a trend towards higher left atrial dimension (p=0.084), interventricular septal thickness (p=0.076), end-diastolic volume (p=0.092), and lower left ventricular ejection fraction (p=0.017). The hepatic steatosis index and triglyceride and glucose index correlated with the cardiac structural and functional parameters (rs=0.176-0.424; p=0.000-0.039). Binary logistic regression demonstrated that higher hepatic steatosis index increased the likelihood of having a high normal left ventricular myocardial mass and high normal stroke volume, while an increase in triglyceride and glucose index was associated with a decrease in stroke volume (R2=0.132; p=0.000). Conclusions. The presence of nonalcoholic fatty liver disease in young adults with cardiometabolic risk factors is associated with changes in cardiac structural and functional parameters. Higher hepatic steatosis index increases the likelihood of a high normal left ventricular myocardial mass and high normal stroke volume, whereas an increase in triglyceride and glucose index increases the likelihood of low normal stroke volume.