Insulin Resistance, Carotid Intima-Media Thickness, Body Mass Index in Patients With Coronary Artery Disease Combined With Metabolic Dysfunction-Associated Steatotic Liver Disease

Objective: To compare the relationship systolic and diastolic blood pressure (BP) with insulin resistance (IR), carotid intima-media thickness and body mass index (BMI) in patients with coronary artery disease (CHD) combined with metabolic dysfunction-associated steatotic liver disease (MASLD). Design and method: We studied 78 patients with CHD in combination with MASLD mean age 58,8±2,14 (group A) and 20 patients with CHD without MASLD mean age 56,6±4,6 (group B). Patients with diabetes were excluded. The study group was divided into 3 subgroups according to BMI (subgroup 1 (36%) - patients who are overweight, 2 (39%) - obesity grade 1, 3 (25%) - obesity grade 2. Studied IR, carotid intima-media thickness depending on BMI. Results: In group A the mean level systolic BP and diastolic BP was higher than in group B (140 [130,0; 160,0], 132,5 [120,0; 150,0], p =0,02 and 90 [85,0; 100,0], 80,0 [75,0; 90,0], p=0,001) 82% of patients with CAD and MASLD had insulin resistance (IR). HOMA1-IR index in patients with 2 class obesity was 3.4 compared to the group of patients with 1 class obesity – 2.35 and overweight patients – 2.26, respectively (p<0.05). Carotid wall thickness was lower in a group A (0,14±0,02 cm) than in a group B (0,16±0,01 cm, p =0,01). Frequency of exposure of atherosclerotic carotid plaques in a group A – 82%, was higher than in a group B – 64% (p <0,05). In group A unstable plaques found significantly more often (31%, p = 0,01), than in the control group B (8%). Conclusions: There was an association between the BMI and level of glucose (r=0,59, p<0,05) in patients with CHD in combination with MASLD. According to HOMA1-IR index IR was detected in 7% of the overweight patients, in 22% patients with 1 class obesity and in 62% with 2 class; and 86%, 72% and 84% according to the HOMA2-IR index, respectively (p<0.05). According to the frequency of unstable carotid plaques, no statistically significant differences were found between groups depending on BMI.