Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention

Abstract

The newly proposed term “metabolic dysfunction-associated fatty liver disease” (MAFLD) is replacing the old term “non-alcoholic fatty liver disease” (NAFLD) in many global regions, because it better reflects the pathophysiology and cardiometabolic implications of this common liver disease. The proposed change in terminology from NAFLD to MAFLD is not simply a single-letter change in an acronym, since MAFLD is defined by a set of specific and positive diagnostic criteria. In particular, the MAFLD definition specifically incorporates within the classification recognized cardiovascular risk factors. Although convincing evidence supports a significant association between both NAFLD and MAFLD, with increased risk of CVD morbidity and mortality, neither NAFLD nor MAFLD have received sufficient attention from the Cardiology community. In fact, there is a paucity of scientific guidelines focusing on this common and burdensome liver disease from cardiovascular professional societies. This Perspective article discusses the rationale and clinical relevance for Cardiologists of the newly proposed MAFLD definition.

Comparative Associations of Nonalcoholic Fatty Liver Disease and Metabolic Dysfunction–Associated Fatty Liver Disease With Coronary Artery Calcification: A Cross-Sectional and Longitudinal Cohort Study

“…NAFLD is now considered an emerging risk factor for atherosclerotic cardiovascular disease (CVD), even after adjustment for traditional CVD risk factors in many investigations. 1–5 With regard to this, a recent American Heart Association statement has highlighted the clinical importance of detecting NAFLD and providing early and appropriate lifestyle measures and pharmacological interventions to prevent both liver-related and CVD-related complications from NAFLD. 1 Many people with NAFLD have metabolic dysfunction and an international expert panel recently proposed that the new term metabolic dysfunction–associated fatty liver disease (MAFLD) should replace the old term NAFLD because MAFLD more appropriately defines this common liver disease and its related metabolic disorders.…”

Increased Serum Adipsin Correlates with MAFLD and Metabolic Risk Abnormalities

“… 46 The MAFLD definition specifically incorporates recognized cardiovascular risk factors, so the future clinical impact of MAFLD on cardiovascular disease should also be concerned. 47 …”

“…46 The MAFLD definition specifically incorporates recognized cardiovascular risk factors, so the future clinical impact of MAFLD on cardiovascular disease should also be concerned. 47 To date, the high prevalence of MAFLD worldwide has attracted increasing attention, and various metabolic risk factors all have a non-negligible impact on MAFLD. At the same time, precision medicine has always been advocated, and risk stratification of diseases and targeted prevention and treatment measures are also necessary.…”

Metabolic dysfunction-associated fatty liver disease increased the risk of subclinical carotid atherosclerosis in China

“…A matched case-control study that included 3306 patients from China showed that MAFLD was significantly associated with the risk of MACEs in patients with chronic coronary syndrome ( 46 ). However, NAFLD/MAFLD still haven’t received sufficient attention from the Cardiology community ( 47 ). The association between MAFLD and CVD/SCA is mainly attributed to their common risk factors, such as obesity and lipid abnormalities ( 48 ).…”