Gut Liver.
2022 Jul;16(4):589-598. 10.5009/gnl210256.
Metabolic Dysfunction-Associated Fatty Liver Disease Better Predicts Incident Cardiovascular Disease
- Affiliations
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- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- 2Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
- 3Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
- 4Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
- 5Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 6Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2531241
- DOI: http://doi.org/10.5009/gnl210256
Abstract
- Background/Aims
Metabolic dysfunction (MD)-associated fatty liver disease is a new positive diagnostic criterion based on hepatic steatosis and MD. However, a comprehensive evaluation on the association of MD and hepatic steatosis with incident cardiovascular disease (CVD) has yet to be performed.
Methods
This retrospective cohort study included 333,389 participants from the Korean National Health Insurance Service database who received a health examination between 2009 and 2010. Hepatic steatosis was defined using the Korean National Health and Nutrition Examination Survey-derived nonalcoholic fatty liver disease scoring system. Cox proportional hazards regression was adopted to determine the adjusted hazard ratio (aHR) with 95% confidence interval (CI) for CVD according to the presence of hepatic steatosis and MD, as well as the composite term.
Results
This study included 179,437 men and 153,952 women with a median age of 57 years. Hepatic steatosis with MD (aHR, 2.00; 95% CI, 1.89 to 2.13) and without MD (aHR, 1.30; 95% CI, 1.10 to 1.54) significantly increased the risk of CVD compared to no steatosis without MD (reference). However, steatosis revealed no significant difference in the risk of CVD compared to no steatosis among participants with one MD (aHR, 1.09; 95% CI, 0.91 to 1.30). In participants with steatosis, the presence of one and ≥2 MDs had aHR values of 1.25 (95% CI, 0.87 to 1.79) and 1.71 (95% CI, 1.22 to 2.41), respectively, compared to no MD.
Conclusions
Combined consideration of hepatic steatosis and MD was significantly associated with increased CVD risk and showed better predictive performance for CVD than hepatic steatosis or MD alone.
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