Metabolic Dysfunction-Associated Steatotic Liver Disease and Peripheral Arterial Disease: Associations and Treatment...

Metabolic dysfunction-associated steatotic liver disease (MASLD) and peripheral arterial disease (PAD) are highly prevalent conditions that increase cardiovascular risk. This review aims to summarize current evidence on the association between MASLD and PAD, with a particular focus on clinical studies. A critical appraisal of this association will enhance understanding of MASLD as a multi-system disease and provide potential therapeutic implications.

A literature search was performed using the PubMed database.

Both MASLD and PAD are multifactorial diseases that share common risk factors and pathogenic mechanisms. Most relevant clinical studies support an association between MASLD and PAD, particularly in the context of hepatic steatosis. Data regarding steatohepatitis or hepatic fibrosis are limited, largely due to the scarcity of studies with biopsy-proven MASLD. Management strategies for MASLD and PAD overlap, emphasizing lifestyle modifications such as a balanced diet, regular exercise, and smoking cessation. Additionally, certain medications used for PAD (e.g., statins, aspirin) or under investigation for MASLD (e.g., glucagon-like peptide-1 receptor agonists, dual and triple peptide agonists) may have beneficial effects on both conditions.

Until clinical trials specifically evaluate medications for patients with concomitant MASLD and PAD, priority should be given to lifestyle interventions and the management of shared comorbidities, including obesity, type 2 diabetes mellitus, arterial hypertension, and dyslipidemia, which may confer benefits for both diseases.

MASLD and PAD frequently coexist. Targeting both conditions is expected to reduce the elevated cardiovascular risk observed in patients affected by both MASLD and PAD.