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MAFLD increases CKM syndrome severity: a NHANES-based cross-sectional study.
Alaa M Mostafa1, Yasser Fouad2, Ziayn Pan3
1Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Main Road, Minia, 11432, Egypt. alaam.mostafa2022@gmail.com.
Clinical and Experimental Medicine
|December 25, 2025
Summary
Metabolic dysfunction-associated fatty liver disease (MAFLD) significantly increases cardiovascular-kidney-metabolic (CKM) risks, especially with liver fibrosis. Early MAFLD detection is vital for CKM risk stratification and intervention.
Area of Science:
- Cardiology
- Nephrology
- Hepatology
- Metabolic Syndrome
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome highlights linked renal and cardiometabolic issues.
- The role of metabolic dysfunction-associated fatty liver disease (MAFLD) in CKM staging remains unclear.
Purpose of the Study:
- To investigate the impact of MAFLD on CKM staging and risk.
- To assess MAFLD as a predictor of advanced CKM stages.
Main Methods:
- Cross-sectional analysis of NHANES data (2017-2020) for 6167 adults (18-80).
- CKM staging based on AHA 2023 classification; MAFLD and liver fibrosis assessed via elastography and non-invasive scores.
- Logistic regression identified predictors of advanced CKM stages.
Main Results:
- 92.3% met CKM criteria; 55.1% had MAFLD (CKM-MAFLD).
- CKM-MAFLD linked to higher cardiometabolic risks and cardiovascular events.
- MAFLD independently predicted CKM risk (OR 1.2), amplified by liver fibrosis (OR 1.36).
Conclusions:
- MAFLD is a significant predictor of CKM risk, particularly in individuals with liver fibrosis.
- Hepatic evaluation is crucial for CKM risk stratification.
- Early MAFLD identification enables targeted interventions across the liver-heart-kidney axis.
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