MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men

Abstract

Background and aim Metabolic dysfunction and associated systemic inflammation are risk factors for chronic obstructive pulmonary disease (COPD) and COPD is highly prevalent in men. We investigated the impact of metabolic-associated fatty liver disease (MAFLD) and MAFLD-related systemic inflammation on COPD in men. Methods We enrolled 2,041 men with fatty liver. Patients were classified into the COPD (n = 420/2041) and non-COPD (n = 1621/2041) groups. COPD and its high-risk group were diagnosed using the Japanese Respiratory Society Disease statement. Systemic inflammation was evaluated using the C-reactive protein (CRP)/albumin ratio. Independent factors for COPD were investigated by multivariate analysis and decision-tree analysis. Results The prevalence of MAFLD was significantly higher in the COPD group than in the non-COPD group. In multivariable analysis, in addition to heavy smoking and aging, MAFLD was identified as an independent factor for COPD (OR 1.46, 95% CI 1.020–2.101, P = 0.0385). Decision-tree analysis showed that MAFLD, rather than heavy smoking, was the most influential classifier for COPD in non-elderly men (14% in MAFLD vs 6% in non-MAFLD groups). MAFLD was also the second most influential factor in elderly men who were not heavy smokers. In both groups, the CRP/albumin ratio was the first classifier for COPD (16% in the high CRP/albumin ratio group vs 3% in the low CRP/albumin ratio group of non-elderly men). Conclusions MAFLD is an independent predictor of COPD in men. MAFLD had a significant impact on COPD through systemic inflammation in men of all ages who were not heavy smokers. MAFLD may be useful to broadly identify COPD in men.

Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysis

“…MAFLD is associated with worse markers of liver damage and fibrosis [ 37 ], factors associated with HCC risk. MAFLD is also associated with higher risk of extrahepatic events such as atherosclerotic cardiovascular disease [ 38 ], reflux oesophagitis [ 39 ], chronic obstructive pulmonary disease [ 40 ], oesophageal squamous cell carcinoma [ 41 ], and Helicobacter pylori negative gastric cancer [ 42 ], highlighting that patient populations are not identical.…”

Demonstration of the impact of COVID-19 on metabolic associated fatty liver disease by bioinformatics and system biology approach

“…Research proved that both MAFLD and COVID-19 could lead to systematic inflammation. [77][78][79][80] Liver-associated diseases, like liver neoplasms, acute liver failure, fatty liver, and liver cirrhosis, also took a significant share in the analysis result. This association between liver disease and hub genes may account for the existence of the mutual promotion between COVID-19 and MAFLD.…”

Shift in prevalence and systemic inflammation levels from NAFLD to MAFLD: a population-based cross-sectional study

“…While the impact of CRP on the MAFLD definition was deemed modest in this study, it is worth noting that CRP exhibited significant differences between groups. In a prior investigation, Tsubasa Tsutsumi et al proposed that CRP/albumin ratio could potentially be a crucial factor influencing COPD morbidity in MAFLD patients [ 42 ]. Therefore, further investigation is warranted to explore the potential value of CRP in the clinical diagnosis of MAFLD.…”