Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder

Aim. To study the frequency of cardiohepatic syndrome and steatosis by the value of controlled attenuation parameter (CAP), fibrosis, and their combination, depending on the degree of glucose metabolism disorder in patients with acute decompensated heart failure (ADHF).Materials and methods. The stu...

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Main Authors: V. V. Tolkacheva, M. L. Diane, N. I. Khutsishvili, I. A. Misan, F. E. Cabello Montoya, I. S. Nazarov, I. P. Smirnov, Zh. D. Kobalava
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2024-10-01
Series:Бюллетень сибирской медицины
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Online Access:https://bulletin.ssmu.ru/jour/article/view/5746
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author V. V. Tolkacheva
M. L. Diane
N. I. Khutsishvili
I. A. Misan
F. E. Cabello Montoya
I. S. Nazarov
I. P. Smirnov
Zh. D. Kobalava
author_facet V. V. Tolkacheva
M. L. Diane
N. I. Khutsishvili
I. A. Misan
F. E. Cabello Montoya
I. S. Nazarov
I. P. Smirnov
Zh. D. Kobalava
author_sort V. V. Tolkacheva
collection DOAJ
description Aim. To study the frequency of cardiohepatic syndrome and steatosis by the value of controlled attenuation parameter (CAP), fibrosis, and their combination, depending on the degree of glucose metabolism disorder in patients with acute decompensated heart failure (ADHF).Materials and methods. The study included 280 patients (53% men, average age 70.1 ± 10.8 years) with ADHF: 72.5% of patients had a history of arterial hypertension, 60% of patients had coronary heart disease. The HbA1c test was performed in all patients to assess the status of glucose metabolism. The patients were divided into groups depending on the results obtained: at HbA1c values < 5.7%, patients were included in the group without glucose metabolism disorders, at HbA1c 5.7–6.4% – in the prediabetes group, at HbA1c ≥ 6.5% – in the type 2 diabetes group. All patients underwent a standard physical examination at admission and at discharge. Clinical and comprehensive assessments of congestion were performed – NT-proBNP, lung ultrasound, liver fibroscan with CAP, and bioelectrical impedance analysis of body composition.Results. The frequency of glucose metabolism disorders in patients hospitalized with ADHF was 57.5% (n = 161), while prediabetes was detected in 17.1% (n = 48) and type 2 diabetes – in 40.4% (n = 113) of patients. We revealed significantly higher incidence of steatosis by CAP value (69 vs. 42%, p < 0.001), fibrosis (80 vs. 64%, p < 0.001), and their combination (59 vs. 30%, p < 0.001), as well as cardiohepatic syndrome (87 vs. 61%, p < 0.001) in patients with ADHF and glucose metabolism disorders compared to individuals with ADHF without glucose metabolism disorders, respectively. The group of ADHF patients with glucose metabolism disorders and a combination of steatosis / fibrosis was characterized by more pronounced manifestations of metabolic syndrome, impaired kidney and liver function, and more pronounced manifestations (both clinical and laboratory) of congestion.Conclusion. In patients with ADHF with glucose metabolism disorders, liver function test and liver fibroscan with CAP allow for identifying the most severe group of patients with a combination of steatosis/fibrosis and pronounced congestion.
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spelling doaj-art-9dc45f853efe4b1aa746baf4b99920582025-08-20T03:37:46ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842024-10-0123310711510.20538/1682-0363-2024-3-107-1153098Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorderV. V. Tolkacheva0M. L. Diane1N. I. Khutsishvili2I. A. Misan3F. E. Cabello Montoya4I. S. Nazarov5I. P. Smirnov6Zh. D. Kobalava7Peoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaPeoples’ Friendship University of RussiaAim. To study the frequency of cardiohepatic syndrome and steatosis by the value of controlled attenuation parameter (CAP), fibrosis, and their combination, depending on the degree of glucose metabolism disorder in patients with acute decompensated heart failure (ADHF).Materials and methods. The study included 280 patients (53% men, average age 70.1 ± 10.8 years) with ADHF: 72.5% of patients had a history of arterial hypertension, 60% of patients had coronary heart disease. The HbA1c test was performed in all patients to assess the status of glucose metabolism. The patients were divided into groups depending on the results obtained: at HbA1c values < 5.7%, patients were included in the group without glucose metabolism disorders, at HbA1c 5.7–6.4% – in the prediabetes group, at HbA1c ≥ 6.5% – in the type 2 diabetes group. All patients underwent a standard physical examination at admission and at discharge. Clinical and comprehensive assessments of congestion were performed – NT-proBNP, lung ultrasound, liver fibroscan with CAP, and bioelectrical impedance analysis of body composition.Results. The frequency of glucose metabolism disorders in patients hospitalized with ADHF was 57.5% (n = 161), while prediabetes was detected in 17.1% (n = 48) and type 2 diabetes – in 40.4% (n = 113) of patients. We revealed significantly higher incidence of steatosis by CAP value (69 vs. 42%, p < 0.001), fibrosis (80 vs. 64%, p < 0.001), and their combination (59 vs. 30%, p < 0.001), as well as cardiohepatic syndrome (87 vs. 61%, p < 0.001) in patients with ADHF and glucose metabolism disorders compared to individuals with ADHF without glucose metabolism disorders, respectively. The group of ADHF patients with glucose metabolism disorders and a combination of steatosis / fibrosis was characterized by more pronounced manifestations of metabolic syndrome, impaired kidney and liver function, and more pronounced manifestations (both clinical and laboratory) of congestion.Conclusion. In patients with ADHF with glucose metabolism disorders, liver function test and liver fibroscan with CAP allow for identifying the most severe group of patients with a combination of steatosis/fibrosis and pronounced congestion.https://bulletin.ssmu.ru/jour/article/view/5746heart failureliver fibroscansteatosisfibrosisglucose metabolism disorder
spellingShingle V. V. Tolkacheva
M. L. Diane
N. I. Khutsishvili
I. A. Misan
F. E. Cabello Montoya
I. S. Nazarov
I. P. Smirnov
Zh. D. Kobalava
Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
Бюллетень сибирской медицины
heart failure
liver fibroscan
steatosis
fibrosis
glucose metabolism disorder
title Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
title_full Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
title_fullStr Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
title_full_unstemmed Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
title_short Liver damage in patients hospitalized with acute decompensated heart failure, depending on the degree of glucose metabolism disorder
title_sort liver damage in patients hospitalized with acute decompensated heart failure depending on the degree of glucose metabolism disorder
topic heart failure
liver fibroscan
steatosis
fibrosis
glucose metabolism disorder
url https://bulletin.ssmu.ru/jour/article/view/5746
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