NON-ALCOHOLIC FATTY LIVER DISEASE AND CARDIOVASCULAR DISEASE: ASSOCIATIONS WITH CLINICAL MARKERS AND METABOLIC ALTERATIONS.
Abstract
INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent metabolic disorders and is closely associated with insulin resistance and cardiometabolic risk. In men of working age, NAFLD frequently progresses to hepatic fibrosis and contributes to early cardiovascular remodelling, which significantly increases morbidity and mortality due to cardiovascular complications rather than liver-related outcomes. METHODS: A cross-sectional clinical-analytical study was conducted in 206 men aged 25-60 years with confirmed NAFLD. Liver fibrosis was assessed by FibroScan®. Serum LOX-1, LDLR and LRP-1 levels were measured using ELISA. Echocardiography, carotid intima-media thickness (cIMT), and flow-mediated dilation (FMD) were performed to evaluate cardiovascular function. Statistical analysis included ANOVA and correlation analysis (p<0.05). RESULTS: Progression of liver fibrosis (F2-F3) was associated with increased insulin resistance, atherogenic dyslipidemia, and reduced hepatic synthetic function (p<0.05). Patients with advanced fibrosis demonstrated early cardiovascular remodelling, including increased cIMT, higher left ventricular mass index, impaired diastolic function (E/e'), and decreased FMD (p<0.05). A significant increase in LOX-1 and a reduction in LDLR and LRP-1 expression indicated a shift toward a pro-atherogenic receptor phenotype (p<0.001). CONCLUSION: Hepatic fibrosis in NAFLD is closely associated with an adverse cardiometabolic profile. Elevated LOX-1 levels may serve as an early biomarker of endothelial dysfunction and increased cardiovascular risk, supporting earlier identification and more intensive management of high-risk patients with NAFLD.