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Increased Cardiovascular and Cerebrovascular Events in Patients With Lean vs Non-lean MASLD: A Multicenter Analysis.

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Lean patients with metabolic dysfunction-associated steatotic liver disease (MASLD) face higher risks of heart failure, cardiovascular events, and mortality compared to non-lean MASLD patients. This highlights a critical need for targeted research and interventions for lean MASLD individuals.

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Area of Science:

  • Cardiology
  • Hepatology
  • Metabolic Diseases

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern linked to cardiovascular disease.
  • While cardiovascular risks in non-lean MASLD are studied, lean MASLD remains under-researched.
  • This study addresses the knowledge gap by comparing cardiovascular outcomes in lean versus non-lean MASLD patients.

Purpose of the Study:

  • To evaluate and compare cardiovascular outcomes in lean MASLD patients versus non-lean MASLD patients.
  • To identify specific risks associated with lean MASLD.
  • To inform future research and clinical management strategies for lean MASLD.

Main Methods:

  • Retrospective cohort study utilizing the TriNetX multi-institutional database.
  • Lean MASLD defined as Body Mass Index (BMI) <25 kg/m2.
  • 1:1 propensity score matching used to balance baseline characteristics; Cox proportional hazards models analyzed outcomes.

Main Results:

  • Lean MASLD patients showed significantly higher rates of heart failure (HR: 1.23), composite cardiovascular events (HR: 1.21), cerebrovascular events (HR: 1.33), and all-cause mortality (HR: 1.48) at 7-year follow-up.
  • Increased risks were observed across 1-, 3-, and 5-year follow-up periods.
  • The study included 67,519 matched patients in both lean and non-lean MASLD groups.

Conclusions:

  • Lean MASLD is associated with significantly elevated risks of cardiovascular events and all-cause mortality compared to non-lean MASLD.
  • Further investigation into the pathophysiology of lean MASLD is warranted.
  • Development of tailored interventions is crucial to improve outcomes for the lean MASLD population.