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Association of NAFLD and Cardiovascular Events: A Systematic Review and Meta-analysis
Mannat K Bhatia1, Archit Garg1, Junaid Ali1
1Department of Internal Medicine, Saint Peter's University Hospital/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Background:
Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly recognized as a risk factor for cardiovascular disease (CVD) but the association remains unclear. This systematic review and meta-analysis aimed to quantify these associations.
Methodology:
We searched multiple databases for articles reporting CVD outcomes in MAFLD and conducted meta-analysis.
Results:
A total of 49 studies encompassing 1,553,770 individuals with MAFLD were included. MAFLD without advanced fibrosis was significantly associated with increased risks of fatal (HR 1.46, 95% CI 1.23-1.73; P <0.01), nonfatal (HR 1.54, CI 1.29-1.84; P <0.01), and combined CVD events (HR 1.60; CI 1.30-1.97; P <0.01). MAFLD with advanced fibrosis was significantly associated with combined CVD events (HR 1.79, CI 1.09-2.92; P <0.01) but not with fatal CVD events (HR 1.23, CI 1.00-1.52; P =0.06) or nonfatal CVD events (HR 1.08, CI 0.82-1.42; P =0.582).
Conclusion:
MAFLD, even without advanced fibrosis, is an independent risk factor for CVD. The risk is amplified with advanced fibrosis, particularly for combined CVD events.
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