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Published on: July 19, 2024
The burden and mortality impact of cardiovascular disease-metabolic dysfunction-associated steatotic liver disease
Siyuan Tan1, Ting Huang2, Zixi Zhang1
1Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
Insights
Cardiovascular disease (CVD) and metabolic dysfunction-associated steatotic liver disease (MASLD) comorbidity is a growing global health issue. This combination significantly increases mortality risk, highlighting the need for integrated prevention strategies.
Area of Science:
- Epidemiology
- Cardiology
- Hepatology
Background:
- Cardiovascular disease (CVD) and metabolic dysfunction-associated steatotic liver disease (MASLD) share metabolic links.
- The combined health burden and mortality impact of CVD and MASLD are not well understood.
Purpose of the Study:
- To analyze global and regional trends of CVD and MASLD from 1990 to 2023.
- To investigate the association between CVD-MASLD comorbidity and mortality risk.
Main Methods:
- Utilized Global Burden of Disease (GBD) 2023 data for trend analysis.
- Employed NHANES data with multivariable and survival models to assess comorbidity and mortality.
- Conducted Population Attributable Fraction (PAF) analyses.
Main Results:
- Global CVD burden decreased, while MASLD increased, with regional variations.
- CVD-MASLD comorbidity showed the highest mortality risk (aHR 1.68 all-cause, 2.68 cardiovascular).
- Mortality increased with fibrosis severity; CVD, MASLD, and their comorbidity contributed to 22.4% of cardiovascular deaths.
Conclusions:
- CVD-MASLD comorbidity represents a significant global health concern with elevated mortality.
- Integrating MASLD screening and fibrosis evaluation into cardiovascular prevention is crucial.
Background:
Cardiovascular disease (CVD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are metabolically linked, yet their combined burden and mortality impact remain underexplored.
Methods:
Using Global Burden of Disease (GBD) 2023 data, we assessed temporal and regional trends in CVD, MASLD, and metabolic risk factors. National Health and Nutrition Examination Survey (NHANES) data were subsequently analyzed to examine the association between CVD-MASLD comorbidity and mortality using multivariable and survival models.
Results:
From 1990 to 2023, the global burden of CVD declined steadily, whereas MASLD rose continuously, showing divergent and regionally heterogeneous trends. In high-income countries, CVD indicators decreased despite increasing MASLD burden, whereas this inverse pattern was weaker in upper-middle-income regions. In NHANES, individuals with CVD-MASLD comorbidity exhibited the highest metabolic abnormalities and mortality risk. Compared with those without comorbidities, adjusted hazard ratios were 1.68 for all-cause and 2.68 for cardiovascular mortality. Mortality rose progressively with fibrosis severity. PAF analyses showed that CVD, MASLD, and their comorbidity accounted for 13.3%, 1.3%, and 7.8% of cardiovascular deaths, respectively, totaling 22.4%. These associations demonstrated marked age-related heterogeneity.
Conclusion:
CVD-MASLD comorbidity is an emerging global concern associated with excess mortality, emphasizing the need to incorporate MASLD screening and fibrosis evaluation into cardiovascular prevention strategies.
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