Cardiometabolic index as a new predictor of non-alcoholic fatty liver disease: Potential for use it in diagnosis and evaluation therapy

Non-alcoholic fatty liver disease (NAFLD) is an important component of the cardio-renal-hepato-metabolic continuum, requiring timely diagnosis. Available diagnostic tools do not always accurately detect liver steatosis at early stages. A promising solution in this case is the use of the cardiometabolic index (CMI), which can improve the accuracy of screening and risk stratification.

The aim: to evaluate the diagnostic utility of CMI as a potential NAFLD predictor and analyze its dynamics during therapy with ursodeoxycholic acid (UDCA – Ursosan Forte).

Material and methods. The study included 120 patients (68 female and 52 male individuals, median age 55 [47; 63] years) with confirmed NAFLD based on abdominal ultrasound and magnetic resonance imaging with proton density adipose tissue evaluation (MRI-PDFF). CMI was calculated basing on anthropometric and laboratory parameters. A subgroup of 30 participants who were prescribed UDCA at a dose of 12 mg/kg of body weight were then followed for 6 months. After 6 months, CMI and MRI-PDFF were recalculated.

Results. CMI demonstrated diagnostic value for the early detection of hepatic steatosis. In 84.6% of male and 86.8% of female patients with proven hepatic steatosis, the index values were above the cutoff figures, allowing its use for NAFLD screening. A statistically significant correlation between CMI values and the degree of steatosis was revealed (r_s = 0.296, p < 0.001), gender differences of this correlation were identified. UDCA therapy (12 mg/kg/day for 6 months in combination with non-pharmacological measures for NAFLD correction) significantly reduced liver fatty infiltration according to MRI-PDFF from 10 to 6.5% (p = 0.008), as well as a decrease in CMI as an integral indicator of cardiometabolic disorders.

Conclusion. CMI can be used as an auxiliary tool not only for identifying patients with NAFLD but also for assessing the efficacy of therapy. The use of UDCA promotes steatosis regression and reduces cardiovascular risks.