Abstract:

Objective To assess the diagnostic effectiveness of intercellular adhesion molecule-1 （ICAM-1）， vascular cell adhesion molecule-1 （VCAM-1）， and the triglyceride-glucose index （TyG index） in detecting abnormalities of carotid artery intima-media thickness （IMT） in elderly hypertensive patients with metabolically associated steatotic liver disease （MASLD）. Methods A retrospective analysis was carried out on 189 elderly hypertensive patients with MASLD who were admitted to our institution between June 2021 and July 2023. All the subjects had their carotid IMT measured by color Doppler ultrasound and were classified into two groups： the normal group （IMT < 1.0 mm） and the thickened group （IMT ≥ 1.0 mm） according to the ultrasound results. Clinical data collection involved quantifying serum ICAM-1 and VCAM-1 by enzyme - linked immunosorbent assay （ELISA）， calculating the triglyceride glucose （TyG） index from fasting glucose and triglyceride levels， and conducting a comparative analysis of the differences in relevant parameters between the groups. Multivariate logistic regression was used to identify the independent risk factors for IMT thickening， and Pearson correlation analysis was employed to assess the relationships between serum biomarkers and the IMT status. The diagnostic performance was evaluated through receiver operating characteristic （ROC） curve analysis. Results IMT thickening was detected in 71 patients （37.57%）. In comparison with the normal IMT group， the thickened IMT group showed significantly higher levels of systolic/diastolic blood pressure， triglycerides， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， serum ICAM - 1， VCAM - 1， and TyG index （all P < 0.05）. Logistic regression analysis confirmed that these parameters were independent risk factors for IMT thickening. The levels of serum ICAM - 1， VCAM - 1， and TyG index were positively correlated with IMT thickening （IMT ≥1.0 mm） （all P < 0.05）. ROC analysis indicated that the combined biomarker assessment had better diagnostic accuracy than individual markers （P < 0.05）. Conclusions Serum ICAM-1， VCAM-1， and the TyG index exhibit high diagnostic sensitivity and specificity for IMT abnormalities in this patient population， which validates their utility as adjunctive tools for carotid artery lesion risk stratification in elderly hypertensive patients with MASLD.

Key words: serum intercellular adhesion molecule-1, vascular cell adhesion molecule-1, triglyceride-glucose index, metabolic dysfunction-associated steatotic liver disease with hypertension, carotid intima-media thickening