Metabolic dysfunction-associated fatty liver disease and cardiovascular disease: A meta-analysis

Abstract

BackgroundMetabolic dysfunction-associated fatty liver disease [MAFLD, formerly known as nonalcoholic fatty liver disease (NAFLD)] is one of the most important causes of liver disease worldwide, while cardiovascular disease (CVD) is still one of the main causes of morbidity and mortality worldwide, and the two are closely related. This study aimed to investigate the risk of CVD incidence or CVD-related mortality (CVD mortality) in patients diagnosed with MAFLD under new concepts and new diagnostic criteria.MethodsWe searched English databases PubMed, Web of Science, Embase, and Cochrane Library for relevant literature. The language was restricted to English.ResultsBy 22 January 2022, 556 published studies were obtained through preliminary retrieval, and 10 cohort studies were included in this study. All statistical analyses were performed using Review Manager 5.2 software. Compared with the control group, patients in the MAFLD group had a significantly higher relative risk of CVD incidence or CVD mortality during the follow-up, with an RR rate of 1.95 (95% CI 1.76–2.17, p < 0.01). The incidence of CVD in the MAFLD group was more than twice that in the control group (RR 2.26, 95% CI 2.00–2.54, p < 0.01). The mortality rate of CVD was 1.57 times higher than that in the control group (RR 1.57, 95% CI 1.42–1.72, p < 0.01).ConclusionsPatients diagnosed with MAFLD alone had higher cardiovascular mortality than those diagnosed with NAFLD alone based on the available data.

Comparison between metabolic-associated fatty liver disease and nonalcoholic fatty liver disease: From nomenclature to clinical outcomes

“…While steatosis confers a lesser risk of CVD compared to steatohepatitis, the overall individual risk of CVD ultimately stems from the combination of the stage of fatty liver disease and the presence of other cardiometabolic risk factors. Patients with steatohepatitis and /or advanced fibrosis and those with co-existing T2DM are considered special risk groups for significant cardiovascular events and mortality[ 147 ].…”

An international multidisciplinary consensus statement on MAFLD and the risk of CVD

“…Similar results were reported in other Asian cohort studies [ 30 , 31 ]. Finally, a global meta-analysis by Wen et al [ 32 ] confirmed that the incidence rates of CVD in patients with MAFLD were more than twice compared to those observed in subjects without MAFLD.…”

“…In a nationwide cohort study from South Korea (9.5 million participants), Lee et al [ 30 ] reported that patients with MAFLD were at higher risk of CVD mortality (HR 1.46; 95% CI 1.41–1.52) compared to individuals without either MAFLD or NAFLD, whereas patients with NAFLD were not (HR 1.12; 95% CI 0.96–1.30). The aforementioned meta-analysis by Wen et al [ 32 ] confirmed that CVD mortality was ~ 1.6 times higher in patients with MAFLD than in the control group. Collectively, therefore, accumulating evidence now indicates that MAFLD can identify subjects with poorer “metabolic health status” and higher risk of developing CVD events and mortality.…”

Development of LXR inverse agonists to treat MAFLD, NASH, and other metabolic diseases

“…Like NAFLD, dyslipidemia is not constant across the stages of MAFLD ( 19 ). Typically, circulating levels of VLDL and LDL are increased in earlier stages, then as MAFLD progresses, patients will develop hepatic fibrosis and circulating levels of apoB-containing lipoproteins decrease ( 4 , 11 , 25 , 28 ). Therefore, research indicates that dyslipidemia in MAFLD appears the most pronounced at the earlier stages of the disease.…”