Cardiovascular Assessment of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD), represents a growing global health concern, affecting over 25% of adults worldwide. The disease spectrum ranges from asymptomatic steatosis to advanced metabolic dysfunction-associated steatohepatitis (MASH), which predisposes individuals to severe complications, such as cirrhosis and hepatocellular carcinoma. MASLD shares a complex pathophysiological overlap with cardiovascular disease (CVD), with both conditions influenced by common risk factors, such as insulin resistance, obesity, dyslipidemia, and hypertension. These shared mechanisms, including impaired glucose metabolism, endothelial dysfunction, and vascular inflammation, significantly increase the risk of cardiovascular events in MASLD patients. Moreover, racial and ethnic disparities further complicate the management of MASLD and CVD, highlighting the need for tailored screening and intervention strategies. This review explores the intertwined relationship between MASLD and CVD, focusing on their shared risk factors, mechanisms, and the importance of integrated, multidisciplinary care to mitigate the elevated cardiovascular risks in this high-risk patient population. Early diagnosis, effective risk stratification, and comprehensive management are crucial for reducing long-term morbidity and mortality in patients with MASLD.