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MAFLD predicts cardiovascular disease risk better than MASLD
Ziyan Pan1, Gamal Shiha2,3, Gamal Esmat4
1Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia.
Background And Aim:
Metabolic dysfunction-associated steatotic liver disease (MASLD) has been proposed as an alternative for the validated definition of metabolic dysfunction-associated fatty liver disease (MAFLD). We compared the abilities of MAFLD and MASLD to predict the risk of atherosclerotic cardiovascular disease (ASCVD).
Methods:
Six thousand and ninety six participants from the 2017 to 2020 National Health and Nutrition Examination Survey cohort who received a thorough medical health check-up were chosen for the study. The associations between fatty liver status and coronary risk surrogates, such as 10-year ASCVD risk and self-reported cardiovascular events, were analysed.
Results:
MAFLD and MASLD were identified in 2911 (47.7%) and 2758 (45.2%) patients, respectively. MAFLD (odds ratio [OR]: 2.14, 95% confidence interval [CI], 1.78-2.57, p < .001) was more strongly independently associated with high ASCVD risk than MASLD (OR: 1.82, 95% CI, 1.52-2.18, p < .001) was in comparison with the absence of each condition. However, compared with MAFLD, MASLD alone was not associated with increased ASCVD risk. Multiple logistic regression revealed that MAFLD alone was significantly more strongly associated with a high risk of ASCVD (OR: 2.82; 95% CI: 1.13-7.01; p < .03) than MASLD alone.
Conclusions:
Although both MAFLD and MASLD were associated with different ASCVD risks, MAFLD predicted the ASCVD risk better than MASLD. The higher predictive ability of MAFLD compared to MASLD was attributed to metabolic dysfunction rather than moderate alcohol use.
Insights
Metabolic dysfunction-associated fatty liver disease (MAFLD) better predicts atherosclerotic cardiovascular disease (ASCVD) risk than the proposed metabolic dysfunction-associated steatotic liver disease (MASLD) definition. MAFLD
Area of Science:
- Hepatology
- Cardiology
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a proposed alternative to metabolic dysfunction-associated fatty liver disease (MAFLD).
- Understanding the comparative predictive value of these definitions for cardiovascular risk is crucial.
Purpose of the Study:
- To compare the abilities of MAFLD and MASLD definitions in predicting atherosclerotic cardiovascular disease (ASCVD) risk.
- To evaluate the association between fatty liver status and cardiovascular risk surrogates.
Main Methods:
- Analysis of 6,096 participants from the 2017-2020 National Health and Nutrition Examination Survey.
- Assessment of 10-year ASCVD risk and self-reported cardiovascular events in relation to fatty liver status.
Main Results:
- MAFLD identified in 47.7% and MASLD in 45.2% of participants.
- MAFLD showed a stronger independent association with high ASCVD risk (OR: 2.14) compared to MASLD (OR: 1.82).
- MAFLD alone was significantly more associated with high ASCVD risk (OR: 2.82) than MASLD alone.
Conclusions:
- MAFLD demonstrates superior predictive ability for ASCVD risk compared to MASLD.
- The enhanced predictive power of MAFLD is linked to metabolic dysfunction rather than alcohol consumption.
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