Abstract
BACKGROUND AND AIM: This study estimated the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) according to cardiometabolic risk factors. The long-term impacts of MASLD on all-cause and cardiometabolic-specific mortality were evaluated.
METHODS: We enrolled 343 816 adults aged ≥30 years who participated in a health screening program from 1997 through 2013. MASLD was identified on the basis of abdominal ultrasonography and metabolic profiles. The participants were further categorized by liver enzyme elevation. Baseline cardiometabolic comorbidities were classified on the basis of self-reported medication use and clinical seromarkers. All-cause and cardiometabolic-specific deaths were determined through computerized data linkage with nationwide death certifications until December 31, 2020.
RESULTS: The overall prevalence of MASLD was 36.4%. Among patients with MASLD, 35.9% had abnormal liver enzyme levels. Compared with patients without MASLD, abnormal liver enzymes were positively associated with cardiometabolic comorbidities in patients with MASLD (P for trend < 0.001). After follow-up, patients with MASLD had a 9%-29% higher risk of all-cause, cardiovascular-related, or diabetes-related mortality. In the groups with MASLD and elevated and normal liver enzyme levels, the multivariate-adjusted hazard ratios for cardiovascular deaths were 1.14 (1.05-1.25) and 1.10 (1.03-1.17), respectively, and those for diabetes deaths were 1.42 (1.05-1.93) and 1.24 (0.98-1.57), respectively, compared with those in the non-MASLD group (P for trend < 0.001).
DISCUSSION: Individuals with MASLD and elevated liver enzyme levels exhibited significantly higher risks of all-cause and cardiometabolic deaths and should be monitored and given consultation on cardiometabolic modifications.
Original language | English |
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Pages (from-to) | 1939-1949 |
Number of pages | 11 |
Journal | Journal of Gastroenterology and Hepatology (Australia) |
Volume | 39 |
Issue number | 9 |
DOIs | |
State | Published - 09 2024 |
Externally published | Yes |
Bibliographical note
© 2024 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.Keywords
- long-term risk
- nonalcoholic fatty liver disease
- noncommunicable diseases
- Cardiovascular Diseases/mortality
- Prevalence
- Metabolic Diseases/epidemiology
- Humans
- Middle Aged
- Risk Factors
- Alanine Transaminase/blood
- Male
- Cardiometabolic Risk Factors
- Time Factors
- Female
- Adult
- Aged
- Liver/diagnostic imaging
- Fatty Liver/mortality