RELATIONSHIP BETWEEN HEPATORENAL INDEX AND ECHOGENICITY OF CAROTID ATHEROSCLEROTIC PLAQUES ACCORDING TO GSM-ANALYSIS IN PATIENTS WITH ASYMPTOMATIC CAROTID ATHEROSCLEROSIS

Highlights

• The severity of liver steatosis is inversely correlated with the echogenicity of carotid atherosclerotic plaques in middle-aged patients with carotid atherosclerosis.
• Hepatorenal index is an ultrasound marker of hypoechoic carotid atherosclerotic plaques.
• The inclusion of liver steatosis in cardiovascular risk stratification systems can potentially improve the prediction of adverse cardiovascular events.

Annotation

Aim. To study the relationship between hepatorenal index (HRI) and echogenicity of carotid atherosclerotic plaques (CAP).

Methods. The study included patients with CVD risk factors. The patients' age ranged from 40 to 64 years. The ultrasound study of the brachiocephalic arteries was carried out in standard modes. Echogenicity of CAP in carotid arteries was assessed by GSM-analysis. HRI was defined as the ratio of the median gray scale of the liver to the median gray scale of the kidney. Severity of hepatic steatosis was determined by semiquantitative method using Hamaguchi scale.

Results. 139 patients underwent examination according to a unified protocol. Among those patients 104 were selected for the analysis. Assessing the relationship between echogenicity of carotid CAPs, Hamaguchi scale score and HRI, we have found inverse statistically significant correlations. The median GSM of CAP in the study group was 57,0 (39,7; 80,0) conventional units. In order to determine the potential diagnostic value of Hamaguchi scale and HRI for detecting CAPs with lower than median echogenicity for the given group of patients, we performed ROC analysis. According to logistic regression analysis adjusted for sex, age, obesity, and abdominal obesity, an increase in HRI greater than 1,34 was associated with increased odds ratio of carotid CAPs with GSM < 57 conventional units (less than 50^th percentile) by a factor of 2,66 (95% CI 1,09–6,45; p = 0,031), whereas the increase associated with CAPs with GSM < 39,7 conventional units (less than 25^th  percentile) was 2,95-fold (95% CI 1,08–8,08; p = 0,035).

Conclusion. The severity of hepatic steatosis as assessed by the Hamaguchi scale and HRI was inversely correlated with the echogenicity of carotid CAPs in middle-aged patients with carotid atherosclerosis. An increase in HRI > 1,34 with 65,8% probability predicted the presence of carotid CAPs with a GSM of less than 57. Odds ratio of carotid CAPs with GSM < 57 conventional units (less than the 50^th percentile) and GSM < 39,7 (less than 25^th percentile) with HRI values > 1,34 were 2,66 and 2,95, respectively, after adjustment for intervening factors.

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