Adipo-neuroinflammation, cognitive impairment and surrogate markers of cardiovascular risk in patients with MASLD

Abstract

Aim. The epidemiological burden MASLD have been slowly increasing in recent years. Starting from a background of metabolic dysfunction, we evaluated the associations between adipo-neuroinflammation markers (LCN2), indicators of cognitive impairment (MMSE score), surrogate cardiovascular risk indicators (RHI, IMT and MMEE), and MASLD.
Methods. In this cross-sectional study, we enrolled a group of 40 patients with a recent diagnosis of MASLD and a control group of 40 patients with no history of liver disease.
Results. Compared with the controls, patients with MASLD had higher serum levels of LCN2, lower RHI and MMEE values, and lower MMSE scores; univariate analysis also revealed that the differences between the groups in terms of heart rate, body weight, body mass index, body surface area, glycated haemoglobin, and echocardiographic variables (interventricular septal thickness, LVPWT, EF, LAVI, and E/A ratio) were statistically significant. Multinomial regression revealed that the presence of MASLD was significantly positively associated with LVPWT and LCN2, and significantly negatively associated with the RHI. With regards to assessments of cognitive impairment, the presence of MASLD was significantly negatively associated with the MMSE score. We also performed ROC curve analysis to explore the ability of RHI to predict MASLD; the results yielded an AUC of 0.826 (95% CI: 0.72–0.90; p<0.0005) at an optimal cut-off value of 1.87 (sensitivity=72.5%, specificity=90%), suggesting that the RHI can serve as a marker of endothelial dysfunction and thus as an indirect indicator of cardiovascular risk in patients with MASLD.
Conclusions. Patients with MASLD have greater cognitive impairment than controls; they also have higher serum levels of LCN-2 and greater endothelial dysfunction. These results imply that subjects with MASLD have a worse cardiovascular risk profile in addition to more pronounced cognitive impairment than controls do, thus suggesting that liver plays a greater role than simply serving as the metabolic centre.