Metabolic Associated Fatty Liver Disease Increases the Risk of Systemic Complications and Mortality. A Meta-Analysis and Systematic Review of 12 620 736 Individuals

Effect of cofactors on NAFLD/NASH and MAFLD. A paradigm illustrating the pathomechanics of organ dysfunction

“…However, these do not necessarily need to be ruled out and reported in MAFLD diagnosis. MAFLD, on the other hand, probably offers the advantage of more accurately identifying the risk of target organ dysfunction, namely, progressive liver disease [ 120 ] , diabetes and chronic kidney disease [ 121 ] , atherosclerosis [ 122 ] , more severely impaired lung function [ 123 ] , colon cancer [ 124 ] , both intrahepatic and extrahepatic events [ 125 ] , and mortality [ 126 ] , although the last outcome is controversial [ 127 ] .…”

Hepatic steatosis and advanced fibrosis are independent predictors of mortality in acute myocardial infarction without standard modifiable risk factors

“…Insight from the SMuRF‐less population offers unique and timely perspectives on the association of unconventional modifiable risk factors of AMI, such as hepatic steatosis, and its associated outcomes, over and beyond traditional drivers of atherosclerosis. We have previously reported that hepatic steatosis and fibrosis are not only the hepatic manifestation of metabolic dysfunction, 8 but fatty liver disease can also independently increase the cardiovascular risk of the individual by 49% 9 . We postulate that hepatic steatosis may be more than a bystander, but rather it may be a driver for atherosclerosis and mortality post AMI.…”

“…We have previously reported that hepatic steatosis and fibrosis are not only the hepatic manifestation of metabolic dysfunction, 8 but fatty liver disease can also independently increase the cardiovascular risk of the individual by 49%. 9 We postulate that hepatic steatosis may be more than a bystander, but rather it may be a driver for atherosclerosis and mortality post AMI. Hepatic steatosis is a systemic disease that contributes to intrahepatic lipid accumulation, adiponectin, atherogenic dyslipidaemia, insulin resistance, 10,11 and ultimately atherosclerosis progression.…”

Nonalcoholic fatty liver disease versus metabolic-associated fatty liver disease: Prevalence, outcomes and implications of a change in name

“…Finally, since the disease burden of fatty liver disease is vast, increased engagement among the care provider community beyond liver specialists is needed, and the nomenclature that directly indicates “metabolic” derangement can help engage care providers in other disciplines such as cardiology and endocrinology in the screening, diagnosis, and management of patients with fatty liver and metabolic disease, namely MAFLD. A recent meta-analysis of over 12 million people found a significantly higher prevalence of a wide range of systemic complications in individuals with MAFLD compared to those without MAFLD, including cardiovascular disease, extrahepatic maglinancy and CKD [ 57 ]. This emphasizes the importance of multidisciplinary engagement in the management of patients with MAFLD.…”

“…Further studies characterizing non-obese MAFLD are required as prior studies have suggested that non-obese NAFLD people may have higher mortality than obese people with NAFLD [ 71 - 75 ]. While MAFLD provides a greater focus on extrahepatic comorbidities associated with fatty liver, it potentially might result in an overemphasis on the systemic comorbidities that may result in a lack of focus on the liver itself, even though the higher risk of complications and disease could well be attributed to the presence of systemic dysregulation, rather than from the liver [ 57 ].…”