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Association between antibiotic use and cardiovascular diseases in metabolic dysfunction-associated steatotic liver

Ju Hyun Kang1,2, Sun Jae Park1, Seogsong Jeong3

  • 1Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.

Hepatology Research : the Official Journal of the Japan Society of Hepatology
|September 30, 2024
PubMed
Abstract

Insights

Prolonged antibiotic use significantly increases cardiovascular disease (CVD) risk in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This highlights a potential link between antibiotic exposure and CVD in this population.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent.
  • Cardiovascular diseases (CVD) are a leading cause of mortality.
  • Previous research suggests links between antibiotic use, metabolic dysfunction, and CVD risk.

Purpose of the Study:

  • To investigate the association between antibiotic exposure and the risk of developing CVD in patients with MASLD.
  • To quantify the impact of cumulative antibiotic prescription days and the number of antibiotic classes on CVD risk in MASLD patients.

Main Methods:

  • Utilized the Korean National Health Insurance Service database (2013-2019).
  • Included 276,520 adults aged 40+.
  • Defined MASLD using fatty liver index ≥60.
  • Categorized antibiotic exposure by cumulative days and number of classes.
  • Employed multivariate Cox models to assess CVD risk, adjusting for covariates.

Main Results:

  • Patients with MASLD and ≥91 days of antibiotic exposure showed a 1.56-fold increased CVD risk (aHR, 1.56; 95% CI, 1.39-1.74).
  • Patients with MASLD and ≥4 classes of antibiotics exhibited a 1.49-fold elevated CVD risk (aHR, 1.49; 95% CI, 1.34-1.66).
  • Sensitivity analyses confirmed these findings.

Conclusions:

  • Prolonged antibiotic exposure is a significant risk factor for CVD in MASLD patients.
  • Findings suggest an epidemiological basis for antibiotic use considerations in MASLD management.
  • Further research is warranted to elucidate the complex relationship between antibiotics, MASLD, and CVD.
Keywords:
antibioticscardiovascular diseasecohort studymetabolic dysfunction‐associated steatotic liver diseaserisk factor

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