Related Experiment Video
Updated: May 12, 2026
06:26
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Cardiovascular and Hepatic Outcomes: Prognostic Differences Across MASLD-MetALD-ALD Continuum
Han Ah Lee1, Gi-Ae Kim2, Won Kim3,4
1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
Clinical and Molecular Hepatology
|May 10, 2026
Summary
The new steatotic liver disease (SLD) classification reveals distinct patient groups. Cardiovascular risks dominate metabolic dysfunction-associated SLD, while liver disease progression is key in alcohol-associated SLD.
Area of Science:
- Hepatology and Gastroenterology
- Cardiovascular Medicine
- Metabolic Diseases
Background:
- Steatotic liver disease (SLD) nomenclature has shifted, introducing metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), and alcohol-associated liver disease (ALD).
- SLD subtypes represent a continuum influenced by metabolic dysfunction and alcohol.
- Evidence shows distinct outcome clusters within SLD, driven by varied pathogenic factors and clinical paths.
Purpose of the Study:
- To review cardiovascular and hepatic outcome patterns across the MASLD-MetALD-ALD spectrum.
- To highlight prognostic shifts and risk stratification strategies for steatotic liver disease.
Main Methods:
- Synthesis of evidence on cardiovascular and hepatic outcomes across the SLD spectrum.
- Analysis of outcome patterns in large-scale cohorts.
- Review of risk factors including fibrosis, alcohol exposure, and metabolic dysfunction.
Main Results:
- Cardiometabolic clusters are prominent in MASLD, increasing cardiovascular disease (CVD) risk.
- Liver-specific clusters show progressive fibrosis, cirrhosis, and hepatocellular carcinoma, particularly in ALD.
- CVD causes 40-50% of MASLD deaths, while liver mortality exceeds 60% in ALD.
- Advanced fibrosis amplifies both CVD and hepatic risks across all SLD subtypes.
- Hepatic outcomes increase with alcohol exposure, while CVD risk is a significant burden across subtypes.
Conclusions:
- The MASLD-MetALD-ALD spectrum demonstrates a shift in dominant mortality drivers, from CVD in MASLD to liver-related causes with increased alcohol exposure.
- Advanced fibrosis is a critical shared determinant of adverse outcomes.
- Outcome-oriented risk stratification using noninvasive fibrosis assessment, alcohol biomarkers, and CVD risk calculators is recommended.
- Individualized management of SLD as a modifiable continuum can optimize multisystem outcomes.
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