Risk factors of coronary artery disease in metabolic-associated fatty liver disease: a single center cross-sectional study

TL;DR

This study identifies key risk factors for coronary artery disease in people with fatty liver disease, highlighting a new inflammatory biomarker called MHR.

Contribution

The study introduces MHR as a novel inflammatory biomarker with significant predictive value for CAD in MAFLD patients.

Findings

Gender, age, WBC, TC, and MHR were significant risk factors for CAD in MAFLD patients.

MHR showed strong predictive value for CAD with an AUC of 0.701.

Patients in the highest MHR quartile had significantly elevated CAD risk.

Abstract

The specific risk factors contributing to coronary artery disease (CAD) in individuals with metabolic-associated fatty liver disease (MAFLD) have not been comprehensively examined. Given the critical role of inflammation in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD), the monocyte to high-density lipoprotein cholesterol ratio (MHR) has emerged as a novel and significant inflammatory biomarker linked to CAD. Therefore, the primary objective of this study was to identify the risk factors associated with CAD in the MAFLD population, to analyze and compare MHR levels in MAFLD patients with and without concurrent CAD, and to evaluate the diagnostic and predictive value of MHR for CAD incidence within this high-risk cohort.

In total, 251 patients with MAFLD, comprising 151 individuals with CAD and 100 without CAD, were included in the study conducted at the First People's Hospital of Yangquan. The diagnosis of CAD was established through coronary angiography. Biochemical indices were collected and subjected to logistic regression analysis to identify markers that exhibited differential expression between MAFLD patients with CAD and those without CAD. These markers were subsequently integrated into a diagnostic model. The predictive efficacy of this model was evaluated using Decision Curve Analysis (DCA). Furthermore, the relationship between the MHR and other markers was examined using Spearman's correlation analysis.

Gender, age, white blood cell count (WBC), total cholesterol (TC), and the MHR were identified as significant risk factors for CAD in patients with MAFLD. Based on the area under the curve (AUC) value, the diagnostic model incorporating these five risk factors demonstrated robust diagnostic performance, with an AUC of 0.809. The DCA further validated its diagnostic effectiveness. Additionally, MHR was found to possess substantial diagnostic value for the occurrence of CAD events in MAFLD patients, with an AUC of 0.701. Further analysis of MHR quartiles revealed that patients in the highest quartile exhibited a significantly elevated risk of CAD compared to those in the other three quartiles. Moreover, significant correlations were observed between MHR and body mass index, WBC, uric acid, creatinine and triglycerides.

The findings confirmed the importance of gender, age, WBC, TC, and MHR in predicting the occurrence of CAD in MAFLD populations, with MHR showing higher predictive value.

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