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Clinical features and mortality outcomes of patients with MASLD only compared to those with MAFLD and MASLD
Mingqian Jiang1,2, Ziyan Pan1, Jacob George1
1Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia.
Background And Aims:
The applicability of the proposed metabolic dysfunction-associated steatotic liver disease (MASLD) definition has not been validated. We aimed to characterize the profiles and long-term survival of people meeting the criteria for MASLD, but not that of metabolic dysfunction-associated fatty liver disease (MAFLD), i.e. MASLD only.
Methods:
Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, 7791 adult participants were included and categorized into four distinct groups: no SLD, non-MAFLD MASLD, MASLD-MAFLD, and cryptogenic SLD (steatosis without metabolic dysfunction).
Results:
Participants in the MASLD-only group were younger and had better metabolic profiles and fibrosis degree compared to those with MASLD-MAFLD and those with no SLD. Their profiles were comparable to those with cryptogenic SLD. Similarly, the MASLD-only group tend to have lower cumulative incidence of all-cause and cardiovascular mortality. Clustering analysis showed that MASLD only clusters differently from individuals with MASLD-MAFLD.
Conclusions:
MASLD only is a distinct clinical group with substantial heterogeneity compared to those captured using the MAFLD criteria.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) only represents a distinct patient group with unique health profiles and survival outcomes, differing from metabolic dysfunction-associated fatty liver disease (MAFLD). This highlights the heterogeneity in liver disease classifications.
Area of Science:
- Hepatology
- Metabolic Disorders
- Public Health
Background:
- The proposed definition for metabolic dysfunction-associated steatotic liver disease (MASLD) requires validation.
- Current understanding of MASLD and its distinction from metabolic dysfunction-associated fatty liver disease (MAFLD) is incomplete.
Purpose of the Study:
- To characterize the clinical profiles of individuals meeting MASLD criteria but not MAFLD criteria (MASLD-only).
- To assess the long-term survival outcomes of the MASLD-only group.
- To compare MASLD-only patients with other steatotic liver disease classifications.
Main Methods:
- Analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III).
- Inclusion of 7791 adult participants.
- Categorization into four groups: no SLD, non-MAFLD MASLD, MASLD-MAFLD, and cryptogenic SLD.
Main Results:
- The MASLD-only group exhibited younger age, better metabolic profiles, and less fibrosis compared to MASLD-MAFLD and no SLD groups.
- MASLD-only profiles were comparable to cryptogenic SLD.
- Lower cumulative incidence of all-cause and cardiovascular mortality was observed in the MASLD-only group.
- Clustering analysis revealed distinct grouping for MASLD-only compared to MASLD-MAFLD.
Conclusions:
- MASLD-only constitutes a clinically distinct entity.
- This group demonstrates significant heterogeneity compared to patients identified solely by MAFLD criteria.
- The findings underscore the importance of refining liver disease classifications.
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