Steatotic liver disease classification is dynamic, affecting clinical trial eligibility and subclass-specific treatments
Abstract
BACKGROUND AND AIMS
Steatotic liver disease (SLD) includes the subclasses metabolic-dysfunction associated steatotic liver disease (MASLD), metabolic and alcohol-related liver disease (MetALD) and alcohol-related liver disease (ALD). We investigated the robustness of the SLD diagnoses after two years.
METHOD
We performed a prospective cohort study among individuals from the general population and individuals at risk of SLD. Participants were classified according to the diagnostic criteria of the SLD nomenclature at baseline and after 2 years.
RESULTS
We included 1042 participants, mean age was 57 (±10) years, 663 were male (64%) and 379 (36%) female and 70 (7%) had advanced fibrosis. At baseline, 595 (57%) had SLD, hereof 371 (62%) met the criteria for MASLD, 140 (24%) for MetALD and 83 (14%) for ALD, and 1 (<1%) were classified as cryptogenic SLD. Median time between the baseline and follow up visit was 25 months (IQR 24-31). Overall, 399 (38%) of the 1042 participants changed SLD classification from baseline to follow-up. In the group without SLD at baseline, 25% had SLD at follow-up. In comparison, 38% with MASLD at baseline were classified differently at follow-up, while 62% and 69% of participants with baseline MetALD and ALD were classified differently at follow-up. The primary reasons for changing classification were that individuals no longer met the criteria for having SLD or had altered their alcohol intake.
CONCLUSION
SLD and the subclassification hereof is highly…
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: 1,042 participants or records.
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