# Positive Association Between Ultrasonographic Fatty Liver Indicator and the Severity of Coronary Artery Disease

## TL;DR

This study shows that a liver fat indicator from ultrasounds is linked to the severity of heart artery disease and improves diagnosis when combined with diabetes status.

## Contribution

The study demonstrates that US-FLI is an independent predictor of CAD severity and improves diagnostic accuracy when combined with T2DM.

## Key findings

- US-FLI was an independent predictor of CAD severity (OR = 1.262, p = 0.028).
- A US-FLI threshold of 2 had 65.22% sensitivity and 55.56% specificity for moderate-severe CAD.
- Combining US-FLI with T2DM improved diagnostic performance (AUC = 0.732, p < 0.001).

## Abstract

Background: This study investigates the link between metabolic dysfunction-associated fatty liver disease (MAFLD) and coronary artery disease (CAD) using the ultrasonographic fatty liver indicator (US-FLI) to assess liver steatosis. Methods: A total of 204 patients were included, with hepatic steatosis evaluated through ultrasound characteristics, diagnosing fatty liver when US-FLI was ≥2. CAD severity was determined using the SYNTAX score (SS), categorizing 100 CAD patients into mild (SS ≤ 22) and moderate-severe (MS) (SS ≥ 23) groups. The association between US-FLI and SS in patients with MAFLD was evaluated through the multivariate logistic regression model. A receiver operating characteristic curve was applied to determine the accuracy, sensitivity, and specificity of US-FLI in predicting SS. Results: In the multivariate logistic regression analysis, US-FLI was an independent predictor of the CAD group (OR = 1.194, 95% CI: 1.008–1.414, p = 0.040) and the MS group (OR = 1.262, 95% CI: 1.025–1.553, p = 0.028). In the receiver operating characteristic curve analysis, a US-FLI value of 2 was found to be the optimal threshold point for diagnosing MS CAD patients (AUC = 0.620, 95% CI: 0.509–0.713, p = 0.039), with a sensitivity of 65.22% and a specificity of 55.56%. The diagnostic performance of MS CAD patients significantly improved when US-FLI was combined with type 2 diabetes mellitus (T2DM) (AUC = 0.732, 95% CI: 0.632–0.832, p < 0.001), with a sensitivity of 65.22% and specificity of 77.78%. Conclusions: US-FLI was independently and positively associated with CAD severity. US-FLI combined with T2DM had better diagnostic performance in patients with MS CAD.