[Association between metabolic dysfunction-associated steatotic liver disease and risk for cardiovascular events in...

Objective: To analyze the association between metabolic dysfunction- associated steatotic liver disease (MASLD) and the risk for cardiovascular events in adults in Shanghai communities. Methods: A community-based prospective cohort study was conducted, based on the Shanghai Suburban Natural Population Cohort and Biobank, in 34 783 adults who were free of cardiovascular events at baseline in Shanghai. Multivariate Cox proportional hazards regression model was used to analyze the association between MASLD and the risk of cardiovascular events. The Fine-gray competing risks model was used to handle the influence of competing risk events in the Cox proportional hazards regression model. Subgroup analyses were performed according to factors that may affect the relationship between MASLD and cardiovascular events, with multiplicative interaction effects examined. Results: A total of 34 783 participants were included in the cohort, with a follow-up time of M (Q₁, Q₃) of 6.90 (6.62, 7.45) years. During follow-up, 2 067 new incident cardiovascular event cases were observed among the 13 837 patients with MASLD, with a cumulative incidence of 5.94%. Multivariate Cox proportional hazards regression analysis showed that MASLD increased the overall risk of cardiovascular events (HR=1.17, 95%CI: 1.06-1.29). Subgroup analysis results showed that significant interaction effects were observed for age, hyperlipidemia, and overweight/obesity on the association between MASLD and cardiovascular events (all P for interaction <0.05). Conclusions: The prevalence of MASLD is relatively high in the adult community population in Shanghai. MASLD is associated with an increased risk of cardiovascular events.