BODY MASS INDEX AND BIOCHEMICAL ALTERATIONS IN PATIENTS WITH STEATOTIC LIVER DISEASE: A CROSS-SECTIONAL STUDY

Background. Steatotic liver disease is closely associated with excess body weight and disturbances of lipid metabolism. Although obesity is one of the major metabolic risk factors for hepatic steatosis, routine biochemical changes accompanying different stages of the disease remain important for identifying patients with an unfavorable metabolic profile. Objective. To evaluate body mass index and serum biochemical characteristics in patients with hepatic steatosis and steatohepatitis and to determine the pattern of lipid abnormalities associated with the clinical spectrum of steatotic liver disease. Materials and methods. A cross-sectional study included 84 adults. Twenty-nine participants without evidence of hepatic steatosis or fibrosis formed the control group, 28 patients had hepatic steatosis, and 27 had steatohepatitis. Body mass index (BMI) was calculated as body weight divided by height squared. Participants were classified as having normal body weight when BMI was <25 kg/m², overweight when BMI was 25.0–29.9 kg/m², and obesity when BMI was ≥30 kg/m². Serum total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were assessed. Quantitative variables with non-normal distributions were presented as median and interquartile range. Differences among three groups were evaluated using the Kruskal–Wallis test. Statistical significance was accepted at p<0.05. Results. Of the 84 participants, 36 had normal body weight, 16 were overweight, and 32 had obesity. Marked alterations in the serum lipid profile were observed across the clinical groups. Median total cholesterol increased from 4.00 [3.28–4.20] mmol/L in controls to 5.31 [4.45–6.90] mmol/L in patients with steatosis and 6.02 [4.34–7.02] mmol/L in patients with steatohepatitis (H=28.838; p<0.001). Triglycerides increased from 1.47 [1.20–1.70] mmol/L to 2.82 [2.12–3.55] mmol/L and 3.00 [2.45–3.55] mmol/L, respectively (H=41.619; p<0.001). HDL-C showed the opposite pattern, decreasing from 1.30 [1.25–1.44] mmol/L in controls to 1.00 [0.92–1.05] mmol/L in the steatosis group and 1.00 [0.98–1.03] mmol/L in the steatohepatitis group (H=56.777; p<0.001). LDL-C increased from 2.10 [1.80–2.28] mmol/L to 2.70 [1.90–3.80] mmol/L and 3.60 [2.45–4.15] mmol/L, respectively (H=23.113; p<0.001). The findings demonstrate a progressive shift toward an atherogenic biochemical profile in patients with steatotic liver disease. Conclusion. Excess body weight is highly prevalent among patients with steatotic liver disease and is accompanied by pronounced metabolic abnormalities. Hepatic steatosis and steatohepatitis are characterized by higher concentrations of total cholesterol, triglycerides, and LDL-C together with lower HDL-C. The combination of BMI assessment and routine biochemical testing may therefore provide a simple approach for identifying patients with a more unfavorable metabolic phenotype who require further evaluation and early metabolic intervention.