ReviewActa biochimica Polonica2026
Beyond biochemistry: multiparametric ultrasound parameters and their molecular correlates in cardio-renal-metabolic syndrome.
Review in Acta biochimica Polonica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
Cardio-renal-metabolic syndrome (CRMS)-characterized by the pathological interplay of visceral adiposity, insulin resistance, chronic kidney disease, and cardiovascular disease-affects over 90% of US adults across its staging spectrum, yet its multi-organ burden remains difficult to assess non-invasively at the point of care. This narrative mini review examines whether multiparametric ultrasound within a single examination can serve as an integrated imaging biomarker set complementary to established molecular markers of CRMS. A narrative search of PubMed (2015-2026) was conducted using PICO-structured queries. The hepatic controlled attenuation parameter and liver stiffness measurement correlate directly with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), CRP, and adipokine dysregulation, with pooled CAP cutoffs of 268-313 dB/m and elastography thresholds of 8.2-13.6 kPa for fibrosis staging in MASLD. Epicardial adipose tissue thickness correlates with circulating IL-17A (r = 0.308), hs-CRP (r = 0.666), and HOMA-IR (r = 0.567-0.580), independently predicting left ventricular diastolic dysfunction beyond BMI. Carotid intima-media thickness tracks eGFR decline longitudinally and predicts cardiovascular mortality in CKD populations. Renal resistive index, with a validated threshold of ≥0.70, independently predicts GFR decline and cardiovascular mortality across diabetic and hypertensive populations. Renal shear wave elastography distinguishes fibrotic from non-fibrotic parenchyma, with 93.1% sensitivity against biopsy. Cross-compartmental correlations and composite imaging-biochemistry models consistently outperform single-parameter approaches. Two critical gaps remain: specific ultrasound values have not been associated with AHA/ACC CKM stages, and no outcome study has validated a multiorgan protocol. Multiparametric ultrasound provides a clinically feasible, evidence-based CRMS assessment that remains to be validated in prospective trials.
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