Impact of cardiometabolic risk factors on hepatic fibrosis and clinical outcomes in MASLD: A population-based multi-cohort study
Abstract
Background & Aims Evaluating five cardiometabolic risk factors (CMRFs) is crucial for diagnosing metabolic dysfunction-associated steatotic liver disease (MASLD). This study investigated the impact of CMRFs on hepatic fibrosis and long-term clinical outcomes in patients with MASLD. Methods Two cross-sectional cohorts (Korean magnetic resonance elastography [n = 6,684] and US vibration-controlled transient elastography [n = 6,230]) were included to assess the impact of five CMRFs and their combinations on hepatic fibrosis. Two longitudinal cohorts (UK Biobank [n = 408,544; mean follow-up, 14.3 years] and Korea National Health Insurance data [n = 355,640; mean follow-up, 11.7 years]) were included to evaluate long-term outcomes, including liver-related events, hepatocellular carcinoma events, and overall, cardiovascular, and liver-related death. The risk of MASLD associated with CMRFs was assessed using logistic or Cox regression analysis, referencing participants without steatotic liver disease. Results Across all four cohorts, patients with type 2 diabetes mellitus had the highest risk of hepatic fibrosis and long-term clinical outcomes. Among the five CMRFs, impaired fasting glucose (CMRF2) was the most significant risk factor for both hepatic fibrosis and long-term clinical outcomes. High blood pressure (CMRF3) was the second most significant risk factor for hepatic fibrosis, following CMRF2. Low high-density lipoprotein cholesterol level (CMRF5) exhibited comparable…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 408,544 participants or records.
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