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Updated: Mar 28, 2026

Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Sudden cardiac arrest in steatotic liver disease with metabolic dysfunction or increased alcohol intake
Joo Hee Jeong1, Yeji Kim2, Sun Young Yim3
1Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Anam Hospital, Seoul, Republic of Korea.
Background:
The relationship between sudden cardiac arrest (SCA) and steatotic liver disease with metabolic dysfunction or alcohol intake remains poorly defined.
Objective:
We aimed to evaluate the characteristics of metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD) and their associations with SCA.
Methods:
We analyzed a random 40% sample of South Korean adults who underwent a national health screening in 2012. Steatotic liver disease was defined by a fatty liver index of ≥60 and classified as MASLD, MetALD, or ALD based on metabolic criteria and alcohol consumption. The primary outcome was SCA identified using diagnostic claim codes through December 2022.
Results:
Among 4,420,306 individuals (mean age 48.1 years; 46.1% female), MASLD, MetALD, and ALD were identified in 451,990 (10.2%), 81,289 (1.8%), and 40,067 participants (0.9%), respectively. SCA occurred in 20,150 individuals (0.5%). Individuals categorized as ALD conferred the highest adjusted risk of SCA (hazard ratio [HR] 2.07; 95% confidence interval [CI] 1.86-2.30), followed by MASLD (HR 1.87; 95% CI 1.77-1.97) and MetALD (HR 1.60; 95% CI 1.45-1.77; all P < .001). The association between MetALD and SCA was stronger in adults younger than 40 years.
Conclusion:
MASLD, MetALD, and ALD were each associated with higher SCA risk, with risk rising markedly in ALD. MetALD did not exceed MASLD in overall SCA risk, but demonstrated a disproportionate impact in younger adults.
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