Endothelial functional status in patients with a comorbid course of metabolic dysfunction­­­­associated steatotic liver disease and arterial hypertension

Objective — to investigate endothelial functional state in patients with a comorbid course of metabolic dysfunction­­­­associated steatotic liver disease (MASLD) and arterial hypertension (AH). Materials and methods. Examinations involved 102 patients, who were allocated into three groups: the main group included 40 patients with MASLD and AH comorbid course; the comparison group consisted of 42 patients with isolated MASLD course, and control group included 20 relatively healthy subjects. The mean patients’ age was 46.23±9.3 years. All patients underwent a collection of complaints, anamnesis, physical and general clinical examination, measurement of blood pressure (BP), daily BP monitoring, determination of endothelial dysfunction indicators (endothelial nitric oxide synthase (eNOS), uric acid (UA), fibrinogen, endothelium­­­­dependent vasodilation of the brachial artery (EDV BA). Results. Significantly decreased levels of eNOS (p=0.001), EDV BA (p=0.001), and increased levels of UA (p <0.05) and fibrinogen (p <0.05) were revealed in the groups of patients with MASLD and AH combined course in comparison with the group of patients with isolated MASLD, as well as in comparison of these groups with the control group (p1 <0.01, p2 <0.01). Thus, the average eNOS levels in patients with comorbid pathology was 295.6±35.67 pg/ml, 356.7±28.34 pg/ml in the group of patients with isolated MASLD and 431.5±25.65 pg/ml in the control group. The average of EDV BA levels among examined patients were the following: 2.11±0.67% in patients with MASLD and AH, 2.15±0.48% in the group of isolated MASLD, and 3.07±0.56% in the control group. The following average UA level were defined: 406.4±25.6 µmol/l in patients with comorbid pathology, 369.3±27.8 µmol/l in the group of patients with MASLD, and (308, 9±15.7) µmol/l in the control group. The average level of fibrinogen in patients with the comorbid course of MASLD and AH was 4.4±1.4 g/l, 3.8±1.3 g/l in patients with isolated MASLD, and 2, 4±1.1 g/l in the control group. In addition, significantly decreased levels of eNOS (p=0.01), EDV BA (p=0.01), and increased levels of UA (p <0.01) were found in patients with MASLD against the background of AH stage II in comparison with patients with MASLD and AH stage I. Conclusions. Analysis of the levels of indicators of endothelial functional state demonstrated correlation between endothelial dysfunction and MASLD development and progression of AH in patients with MASLD and AH comorbid course.