Subclinical target organ damage and composite systemic inflammation indices in abdominal obesity

Aim . To analyse the associations between instrumental and laboratory signs of subclinical target organ damage (TOD) and composite systemic inflammation indices in individuals with abdominal obesity (AO). Material and methods. A cross-sectional study included 122 non-smoking patients aged 40-60 years with low (<1%) or moderate (≥1% and <5%) CVR according to the SCORE scale. The main group consisted of 78 individuals with AO (waist circumference ≥94 cm for men and ≥80 cm for women), the comparison group — 44 individuals without AO. The study included questionnaire surveys, anthropometry, laboratory tests with calculation of inflammation indices (Systemic Inflammation Response Index, SIRI; Systemic Immune-Inflammation Index, SII; Aggregate Index of Systemic Inflammation, AISI; Neutrophil-to-Lymphocyte Ratio NLR; Platelet-to- Lymphocyte Ratio, PLR; Monocyte-to-Lymphocyte Ratio, MLR), echocardiography, ultrasound examination of brachiocephalic arteries (BCA) and abdominal organs. Results . Individuals with AO had a significantly higher prevalence of left ventricular hypertrophy (16.7% vs 2.3%; p=0.017), left ventricular diastolic dysfunction (34.6% vs 2.3%; p<0.001), BCA atherosclerotic plaque (43.6% vs 15.9%; p=0.003) and carotid intima-media thickening (68.0% vs 38.6%; p=0.002), hepatic steatosis (51.3% vs 11.4%; p<0.001), pancreatic steatosis (55.1% vs 4.6%; p<0.001), and hyperuricemia (32.1% vs 11.4%; p=0.015). Epicardial obesity (EO) was detected only in the AO group (29.5%). According to multivariate analysis, LV hypertrophy, diastolic dysfunction and BCA atherosclerosis were independently associated with hypertension, whereas hepatic steatosis, pancreatic steatosis and carotid intima-media thickening were associated with AO. Among the inflammatory indices, SIRI was independently associated with epicardial obesity (OR 3.83; p=0.048), and AISI with pancreatic steatosis (OR 1.003; p=0.017). Conclusion . Individuals with AO and low/moderate CVR have a high prevalence of subclinical TOD, indicating the limitations of traditional risk scales and the need for an individualized approach. In multivariate analysis, SIRI was independently associated with epicardial obesity, and AISI with pancreatic steatosis.