Clinical Study On The Correlation Between Metabolic Associated Fatty Liver Disease And Coronary Artery Atherosclerosis

Objective :To investigate the correlation between Metabolic Associated Fatty Liver Disease(MAFLD)and coronary atherosclerosis and the effect of MAFLD on coronary artery stenosis,to provide new insights into the prevention of cardiovascular disease(CVD)in patients with MAFLD.Methods:Patients who underwent both coronary CT angiography(CCTA)and abdominal ultrasound during their hospitalization at the Second Affiliated Hospital of Kunming Medical University from January 2021 to January 2022 were included as study subjects,and 1164 subjects who met the inclusion and exclusion criteria were selected for the study,and the study subjects’ Demographic data(gender,age,height,weight),important biochemical indicators and vital signs data(blood lipids,blood glucose,glycosylated hemoglobin,liver function,blood pressure,etc.)were collected from the study subjects.Divided into MAFLD group and MAFLD group according to the diagnostic criteria of MAFLD.Comparison of clinical baseline information and CCTA findings between the two groups.Coronary plaque type,degree of stenosis and diseased vessels were assessed according to CCTA results.hepatic steatosis was assessed by ultrasonography.To determine the correlation between MAFLD and CAC,statistically significant variables in the comparison between the two groups were included in univariate and multivariate logistic regression analyses,with plaque type and degree of stenosis as dependent variables,MAFLD and traditional CVD risk factors as independent variables to analyze the correlation between MAFLD and CAC.Results:1.Comparison of general baseline information results between MAFLD groupand non-MAFLD group:Of the 1164 subjects,the number of MAFLD group was 680(58.42%)and thenumber of non-MAFLD group was 484(41.58%).Body Mass Index(BMI)values,Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP),Triglyceride(TG),Low Density Lipoprotein Cholesterol(LDL),alanine transaminase(ALT),fasting plasma glucose(FPG),and uric acid(UA)were significantly higher thanthose in the non-MAFLD group,and the differences were statistically significant.The prevalence of type 2 diabetes,hypertension,obesity and hyperlipidemia weresignificantly higher in the MAFLD group than in the non-MAFLD group,and theuse of lipid-lowering drugs was also significantly higher than in the non-MAFLDgroup,with statistically significant differences.The prevalence of smoking washigher in the MAFLD group than in the non-MAFLD group,and the differencewas statistically significant(P < 0.05).The differences in gender,age andaspartate transaminase(AST)were not statistically significant between the twogroups(P > 0.05).2.Comparison of CCTA results between MAFLD group and non-MAFLDgroupCAC(defined as any plaque in the coronary arteries)was found in 992(79.20%)of 1164 study subjects,and the rate of positive CAC was higher in the MAFLDgroup than in the non-MAFLD group,with no statistically significant difference.calcified plaque(47.05% vs.38.84%),non-calcified plaque(21.18% vs.12.81%),and mixed plaque(27.35% vs.20.66%)were significantly higher than those inthe non-MAFLD group,with a significant difference between the two groups.25.95%(302/1164)of all study subjects had obstructive coronary stenosis(≥50%diameter stenosis),and the number of obstructive coronary stenosis wassignificantly higher in the MAFLD group than in the non-MAFLD group(28.38%vs 22.52%),with a statistically significant difference.In the comparison ofmulti-vessel lesions,the number of multi-vessel lesions was significantly higher inthe MAFLD group than in the non-MAFLD group,and the difference wasstatistically significant(P < 0.05),while there was no significant difference in thecomparison of single-vessel lesions between the two groups.3.Comparison of the results of univariate and multifactor logistic regressionanalysis of traditional risk factors,MAFLD and coronary artery stenosis andplaqueUnivariate logistic regression analysis of traditional risk factors,MAFLD andcoronary stenosis and plaque showed that MAFLD was associated withobstructive coronary stenosis(OR=1.363,95% CI: 1.040-1.787,P=0.025),calcified plaque(OR=1.42,95% CI:1.121-1.800,P=0.004),non-calcified spots(OR=1.83,95% CI:1.323-2.528,P=0.000),and mixed spots(OR=1.43,95%CI:1.083-1.883,P=0.012)were positively correlated.Gender,age,smoking,hypertension,type 2 diabetes,HDL,LDL,and FPG were risk factors for coronaryartery obstructive stenosis.Age,hypertension,type 2 diabetes,LDL,and FPGwere risk factors for calcified plaque.Smoking,BMI,hypertension,LDL,andFPG were non-calcified plaque risk factors.Multifactorial logistic regressionanalysis of MAFLD and coronary atherosclerosis showed that after excluding thecommon CVD risk factors of sex,age,smoking,BMI,hypertension,type 2diabetes,LDL,and FPG,MAFLD was associated with non-calcified spots(OR=1.64,95% CI:1.14-2.35,P=0.007),and mixed spots(OR=1.45,95%CI:0.73-1.38,P=0.020)were independently associated.Conclusion(s):1.Patients with MAFLD have a higher incidence of obstructive coronary artery stenosis(i.e.,coronary heart disease,CHD).2.Patients with MAFLD are more likely to have obstructive stenosis of multiple coronary arteries.3.MAFLD,gender,age,smoking,BMI,hypertension,type 2 diabetes,LDL,FPG are risk factors for CAC;MAFLD is an independent risk factor for non-calcified spots and mixed spots.