Metabolic Dysfunction-Associated Fatty Liver Disease Predicts Long-term Mortality and Cardiovascular Disease

Area of Science:

• Hepatology
• Metabolic Diseases
• Cardiovascular Epidemiology

Background:

• Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly recognized as a distinct entity from nonalcoholic fatty liver disease (NAFLD).
• The independent impact of MAFLD on long-term mortality and cardiovascular disease (CVD) risk requires further elucidation.

Purpose of the Study:

• To investigate the association between MAFLD and future risks of overall mortality and CVD.
• To compare the prognostic value of MAFLD versus NAFLD in a community-based cohort.

Main Methods:

• A prospective community-based cohort study followed 8,919 individuals aged 40-70 for 16 years.
• MAFLD was defined by fatty liver index (FLI ≥60) plus overweight/obesity, type 2 diabetes, or ≥2 metabolic abnormalities.
• NAFLD was defined as FLI ≥60 without secondary causes of hepatic steatosis.

Main Results:

• MAFLD was present in 16.9% of subjects and independently predicted overall mortality (HR, 1.33; 95% CI, 1.05-1.69).
• NAFLD did not show a significant association with overall mortality (HR, 1.20; 95% CI, 0.94-1.53).
• MAFLD predicted CVD (HR, 1.35; 95% CI, 1.13-1.62) initially, but significance diminished with further adjustments. Type 2 diabetes within MAFLD significantly increased mortality (HR, 2.07) and CVD risk (HR, 1.42).

Conclusions:

• MAFLD is an independent predictor of increased overall mortality.
• The presence and type of metabolic dysfunction accompanying MAFLD significantly influence individual risks for mortality and CVD.