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Risk Heterogeneity of Liver-Related Events and Extrahepatic Outcomes Across MASLD Phenotypes and Risk Stratification
Xue Bao1, Xiaowen Zhang2, Dahui Xu3
1Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
International Journal of Endocrinology
|June 9, 2025
Summary
Metabolic dysfunction-associated steatotic liver disease (MASLD) and related conditions increase liver and extrahepatic risks. Phenotypes and fibrosis severity significantly impact these outcomes.
Area of Science:
- Hepatology
- Metabolic Disorders
- Public Health
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a newly proposed term for fatty liver disease.
- Understanding the risks associated with different MASLD phenotypes is crucial.
Purpose of the Study:
- To investigate the associations of various MASLD phenotypes and related steatotic liver disease (SLD) with liver-related and extrahepatic outcomes.
- To assess the impact of fibrosis severity on these risks.
Main Methods:
- Utilized data from 368,886 UK Biobank participants.
- Categorized participants into pure MASLD, MetALD, MASLD with ALD, and MASLD with other etiology.
- Followed participants for a median of 13.7 years to track liver-related events (LREs).
Main Results:
- MASLD and related SLD significantly increased the risk of LREs and extrahepatic cancers.
- Specific phenotypes like MASLD with other etiology showed substantially higher LRE risks (HR 26.5).
- Fibrosis-4 score > 2.67 was associated with a remarkably higher risk of LREs.
Conclusions:
- MASLD and related SLDs pose significant risks for liver and extrahepatic outcomes.
- Risk heterogeneity exists across different MASLD phenotypes.
- Liver fibrosis severity is a critical factor for risk stratification in MASLD.
