Sarcopenic obesity in patients with arterial hypertension and metabolic dysfunction-associated steatotic liver disease: focus on inflammation. Part 1

Purpose. The purpose of the study was to evaluate the nonspecific inflammatory markers in patients with arterial hypertension (AH) and metabolic dysfunction-associated steatotic liver disease (MASLD) depending on the presence of sarcopenic obesity.

Materials and methods. The study included 133 patients of both sexes with AH grade I-II and MASLD, divided into two groups depending on the presence/absence of sarcopenic obesity: group 1 (main) – patients with AH, MASLD, and sarcopenic obesity (n = 34, 25.6%), average age 51.8 ± 6.88 years; group 2 (control) – patients with AH, MASLD without sarcopenic obesity (n = 99, 74.4%), average age 46.4 ± 8.13 years.

Sarcopenic obesity was diagnosed based on the criteria of the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity. The concentration of inflammatory markers (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)) in the blood serum was assessed by enzyme immunoassay, and high-sensitivity C-reactive protein (hs-CRP) by biochemical analysis. Statistical analysis of the obtained data was performed using the SPSS 27.0 statistical software package (IBM, USA). The obtained data were interpreted as reliable, and differences between the indicators were considered significant at p < 0.05.

Results. Patients with sarcopenic obesity had higher hs-CRP values (2.64 (1.37 – 4.18) mg/L vs. 1.76 (0.90–2.87) mg/L, p = 0.033) compared to individuals without obesity. The IL-6 values (2.56 (1.46–3.64) pg/mL vs. 2.07 (1.26 – 3.62) pg/mL, p = 0.142) and TNF-α (1.13 (0.75 – 3.09) pg/mL vs. 0.50 (0.07 – 3.77) pg/mL, p = 0.227) did not differ significantly between the groups. Correlation analysis revealed multiple associations between inflammatory markers, body composition, muscle strength, and function, with the highest degree of association found with hs-CRP levels.

Conclusion. The results of the study indicate that the presence of sarcopenic obesity in patients with AH and MASLD is associated with an increased level of hs-CRP in the blood serum.

The second part of the article will present data on the influence of inflammation markers and pro-inflammatory cytokines on cardiometabolic risks in patients with sarcopenic obesity, AH, and MASLD, and will describe the mechanisms of increasing the risk of metabolic dysfunction associated with liver steatosis and AH, as a key link in the pathophysiology of comorbidity in this category of patients.

1. Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019, vol. 48(1), pp. 16–31. doi: 10.1093/ageing/afy169.

2. Donini L.M., Busetto L., Bischoff S.C. et al. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts, 2022, vol. 15(3), pp. 321–335. doi: 10.1159/000521241.

3. Gritsenko O.V., Gruzdeva O.V., Chumakova G.A., Barbarash O.L. Laboratory markers of osteosarcopenic obesity. Russian journal of cardiology, 2023, vol. 28(12), pp. 133–141. doi:10.15829/1560-4071-2023-5563. (in Russian).

4. Vasyukova O.V., Kasyanova Yu.V., Okorokov P.L., Bezlepkina O.B. Myokines and adi pomyokines: inflammatory mediators or unique molecules of targeted therapy for obesity? Problems of endocrinology, 2021, vol. 67(4), pp. 36–45. doi: https://doi.org/10.14341/probl12779. (in Russian).

5. Krivoshapova K.E., Masenko V.L., Bazdyrev E.D., Barbarash O.L. Osteosarcopenic obesity in cardiovascular patients. Controversial and open issues. Cardiovascular therapy and prevention, 2021, vol. 20(6), pp. 92–98. doi: 10.15829/1728-8800-2021-2787. (in Russian).

6. Berns S., Sheptulina A.F., Mamutova E.M. Sarcopenic obesity: epidemiology, pathogenesis and diagnostic criteria. Cardiovascular therapy and pre vention, 2023, vol. 22(6), pp. 78–85. doi:10.15829/1728-8800-2023-3576. (in Russian).

7. Rinella M.E., Lazarus J.V., Ratziu V. et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Hepatology, 2023, vol. 78(6), pp. 1966–1986. doi.org/10.1097/HEP.0000000000000520.

8. Grigorieva I.I., Raskina T.A., Letaeva M.V. et al. Sarcopenia: pathogenesis and diagnosis. Fundamental and clinical medicine, 2019, vol. 4(4), pp. 105–116. doi: 10.23946/2500-0764-2019-4-4-105-116. (in Russian).

9. Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing, 2010, vol. 39(4), pp. 412–423. doi.org/10.1093/ageing/afq034.

10. de Fátima Ribeiro Silva C., Ohara D. G., Matos A. P. et al. Short Physical Performan ce Battery as a Measure of Physical Performance and Mortality Predictor in Older Adults: A Comprehensive Literature Review. Int J Environ Res Public Health, 2021, vol. 18(20), pp. 10612. doi: 10.3390/ijerph182010612.

11. Bibkov B. Universal calculator for calculating glomerular filtration rate and creatinine clearance. Available at: https://boris.bikbov.ru/2013/07/21/kalkulyator-skf-rascheta-skorosti-klubochkovoy-filtratsii/.

12. Bano G., Trevisan C., Carraro S. et al. Inflammation and sarcopenia: A systema - tic review and meta-analysis. Maturitas, 2017, vol. 96, pp. 10–15. doi: 10.1016/j.maturitas.2016.11.006.

13. Park C-H., Geol Do J., Lee Y-T., Yoon K. J. Sarcopenic obesity associated with high-sensitivity C-reactive protein in age and sex comparison: a two-center study in South Korea. BMJ Open, 2018, vol. 8(9), pp. 1–9. doi: 10.1136/bmjopen-2017-021232.

14. Schrager М.А., Metter E.J., Simonsick E. et al. Sarcopenic obesity and inflammation in the In-CHIANTI study. J Appl Physiol, 2007, vol. 102(3), pp. 919–925. doi: org/10.1152/japplphysiol.00627.2006.

15. Schaap L.A., Pluijm S.M.F., Deeg D.J.H., Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med, 2006, vol. 119(6), pp. 526. e9-17. doi: 10.1016/j.amjmed.2005.10.049.

16. Tuttle C.S.L., Thang L.A.N., Maier A.B. Markers of inflammation and their association with muscle strength and mass: A systematic review and meta-analysis. Ageing Res Rev, 2020, vol. 64, pp. 101185. doi: 10.1016/j.arr.2020.101185.

17. Sardeli A.V, Tomeleri C.M., Cyrino E.S. et al. Effect of resistance training on inflammatory markers of older adults: A meta-analysis. Exp Gerontol, 2018, vol. 111, pp. 188–196. doi: 10.1016/j.exger.2018.07.021.

18. Le Goff C., Laurent T., Kaux J-F., Chapelle J-P. Intense physical exercise related to the emergent generation of cardio-vascular risk markers: a review. JFCJ Biol Sport, 2012, vol. 29, pp. 11–16. doi:10.5604/20831862.979290.

19. Meng Y., Wu H., Yang Y. Relationship of anabolic and catabolic biomarkers with muscle strength and physical performance in older adults: a population-based cross-sectional study. BMC Musculoskelet Disord, 2015, vol. 16, pp. 202. doi: 10.1186/s12891-015-0654-7.

20. Meng D., Pantzaris N., Koniari I. C-reactive protein and frailty in the elderly: a literature review. J Clin Med, 2017, vol. 9, pp. 461–465. doi: 10.14740/jocmr2959w.

21. Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of the World Health Organization Collaborating Center for the Epidemiology of Musculoskeletal Conditions and Aging / Ladang A [et al.] // Tissue Int. – 2023. – Vol. 112, № 2. – Р. 197–217. doi: 10.1007/s00223-022-01054-z.