Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study
Abstract
BACKGROUND & AIMS
An international expert panel proposed a new definition for metabolic dysfunction-associated fatty liver disease (MAFLD) as a name change from nonalcoholic fatty liver disease (NAFLD). The clinical impact of this change on the assessment of cardiovascular disease (CVD) risk is yet unknown. We evaluated the prevalence of fatty liver disease (FLD) and the associated CVD risk using each of these definitions.
METHODS
From a nationwide health screening database, we included 9,584,399 participants (48.5% male) aged 40-64 years between 2009 and 2010. Participants were categorized by presence of NAFLD and MAFLD, separately, and by the combination of the two definitions-Neither-FLD, NAFLD-only, MAFLD-only, or Both-FLD. The primary outcome was a composite CVD event, including myocardial infarction, ischemic stroke, heart failure, or CVD-related death.
RESULTS
The prevalence of NAFLD and MAFLD was 28.0% and 37.3%, respectively. After excluding those with prior CVD, 8,962,813 participants were followed for a median of 10.1 years. NAFLD and MAFLD were each associated with significantly higher risk for CVD events. When the Neither-FLD group was the reference, multivariable-adjusted hazard ratios (95% confidence interval) for CVD events were 1.09 (1.03-1.15) in the NAFLD-only group, 1.43 (1.41-1.45) in the MAFLD-only group, and 1.56 (1.54-1.58) in the Both-FLD group.
CONCLUSIONS
A considerable proportion of middle-aged Korean adults have MAFLD without satisfying the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 9,584,399 participants or records.
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