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Updated: Jul 25, 2025
Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
Metabolic Dysfunction-associated fatty liver disease and incident heart failure risk: the Kailuan cohort study
Zhihao Wei1, Zhe Huang2, Zongshuang Song1
1School of Public Health, North China University of Science and Technology, Tangshan, 063210, China.
Background:
Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed to replace non-alcoholic fatty liver disease (NAFLD) to emphasize the pathogenic association between fatty liver disease and metabolic dysfunction. Studies have found that MAFLD independently increases the risk of myocardial infarction and stroke. But the relationship between MAFLD and heart failure (HF) is not fully understood.
Objectives:
This study aimed to explore the association between MAFLD and the risk of HF.
Methods:
The study included 98,685 participants without HF selected from the Kailuan cohort in 2006. All participants were divided into non-MAFLD group and MAFLD group according to MAFLD diagnostic criteria. After follow-up until December 31, 2020, the Cox regression analysis model was used to calculate the effect of MAFLD on the risk of HF.
Results:
During the median follow-up of 14.01 years,3260 cases of HF were defined, the HF incidence density of non-MAFLD group and MAFLD group was 2.19/1000pys and 3.29/1000pys, respectively. Compared with the non-MAFLD group, participants with MAFLD had an increased risk of HF (HR: 1.40, 95% CI: 1.30-1.50); in addition, an exacerbation of fatty liver disease was associated with an increased risk of HF in people with MAFLD. We also observed a higher risk of HF among the different metabolic dysfunction of MAFLD in people with both fatty liver disease and type 2 diabetes (HR, 1.95; 95% CI, 1.73-2.20).
Conclusions:
Our findings suggest that the risk of HF was significantly increased in participants with MAFLD, and an exacerbation of fatty liver disease was associated with an increased risk of HF in people with MAFLD. In addition, we should pay more attention to people with MAFLD with type 2 diabetes.
Insights
Metabolic dysfunction-associated fatty liver disease (MAFLD) significantly increases heart failure (HF) risk. Individuals with MAFLD and type 2 diabetes face an even higher risk, warranting closer medical attention.
Area of Science:
- Cardiology
- Hepatology
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated fatty liver disease (MAFLD) is proposed to replace NAFLD, highlighting its link to metabolic issues.
- MAFLD is an independent risk factor for myocardial infarction and stroke.
- The association between MAFLD and heart failure (HF) requires further investigation.
Purpose of the Study:
- To investigate the relationship between MAFLD and the risk of developing heart failure (HF).
Main Methods:
- A cohort of 98,685 participants without HF was selected from the Kailuan cohort in 2006.
- Participants were categorized into non-MAFLD and MAFLD groups based on diagnostic criteria.
- Cox regression analysis was employed to assess MAFLD's impact on HF risk over a median follow-up of 14.01 years.
Main Results:
- The MAFLD group exhibited a higher incidence density of HF (3.29/1000 person-years) compared to the non-MAFLD group (2.19/1000 person-years).
- MAFLD was associated with a 1.40-fold increased risk of HF (HR: 1.40, 95% CI: 1.30-1.50).
- Individuals with MAFLD and type 2 diabetes showed a significantly higher risk of HF (HR: 1.95, 95% CI: 1.73-2.20).
Conclusions:
- MAFLD is a significant risk factor for heart failure.
- Worsening fatty liver disease in MAFLD patients correlates with increased HF risk.
- Particular attention should be given to MAFLD patients with co-existing type 2 diabetes.
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