Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States

Kim, Dong‐Hee; Konyn, Peter; Sandhu, Keeryth K; Dennis, Brittany B.; Cheung, Amanda; Ahmed, Aijaz

doi:10.1016/j.jhep.2021.07.035

Cited by 305 publications

(303 citation statements)

References 27 publications

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“…Indeed, a substantial number of such non-diabetic, lean patients with hepatic steatosis may not be evaluable using current MAFLD criteria in the real world due to the lack of all laboratory parameters. The authors reported that MAFLD was associated with increased all-cause mortality after adjusting for metabolic risk factors, while NAFLD was not (1). Further, the adjusted increase in mortality appeared to be predominantly due to an increase in cancer mortality rather than cardiovascular mortality.…”

Section: Sirmentioning

confidence: 96%

“…We read with great interest the study by Kim et al who analysed the NHANES III (National Health and Nutrition Examination Survey) cohort and provided interesting insights into the prognostic outcomes of metabolic dysfunction-associated fatty liver disease (MAFLD) and non-alcoholic fatty liver disease (NAFLD) (1).…”

Section: Sirmentioning

confidence: 99%

“…An additional 4875 (35.2%) patients were further excluded as they did not fast for 8 hours or did not have fasting levels of glucose or insulin (1). As per MAFLD criteria, the definition of metabolic-dysfunction in non-diabetic patients with normal BMI requires a battery of investigations, some of which like hs-CRP and HOMA-IR are not routinely ordered in patients being evaluated for hepatic steatosis in clinical practice (2).…”

Section: Sirmentioning

confidence: 99%

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NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

Ahmad

Mehta

et al. 2022

Journal of Hepatology

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Section: Sirmentioning

confidence: 96%

Section: Sirmentioning

confidence: 99%

Section: Sirmentioning

confidence: 99%

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NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

Ahmad

Mehta

et al. 2022

Journal of Hepatology

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“…7 Recent data suggest that MAFLD but not NAFLD is associated with increased overall and cardiovascular mortality, again highlighting the importance of metabolic dysfunction in the natural history of the disease. 47,74 For example, in the NHANES III 1988-1994 cohort, subjects with MAFLD had a 17% increase in overall mortality at a median follow-up of 23 years. 74 Likewise, subjects who had MAFLD but not NAFLD in the same cohort were more likely to have increased fibrosis-4 index, suggestive of significant liver fibrosis, than those who had NAFLD but not MAFLD.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…47,74 For example, in the NHANES III 1988-1994 cohort, subjects with MAFLD had a 17% increase in overall mortality at a median follow-up of 23 years. 74 Likewise, subjects who had MAFLD but not NAFLD in the same cohort were more likely to have increased fibrosis-4 index, suggestive of significant liver fibrosis, than those who had NAFLD but not MAFLD. 75 In this section, we discuss the various clinical outcomes in patients with MAFLD.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Epidemiology and Clinical Outcomes of Metabolic (Dysfunction)-associated Fatty Liver Disease

Lin¹,

Zhang²,

Li³

et al. 2021

Journal of Clinical and Translational Hepatology

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Metabolic (dysfunction)-associated fatty liver disease (MAFLD) is currently the most common chronic liver disease and affects at least a quarter of the global adult population. It has rapidly become one of the leading causes of hepatocellular carcinoma and cirrhosis in Western countries. In this review, we discuss the nomenclature and definition of MAFLD as well as its prevalence and incidence in different geographical regions. Although cardiovascular disease remains the leading cause of death in MAFLD patients, the proportion of patients dying from hepatic complications increases sharply as the disease progresses to advanced liver fibrosis and cirrhosis. In addition, patients with MAFLD are at increased risk of various extrahepatic cancers. Although a causal relationship between MAFLD and extrahepatic cancers has not been established, clinicians should recognize the association and consider cancer screening (e.g., for colorectal cancer) as appropriate.

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Differential risk of 23 site‐specific incident cancers and cancer‐related mortality among patients with metabolic dysfunction‐associated fatty liver disease: a population‐based cohort study with 9.7 million Korean subjects

Chung

Yoo

et al. 2023

Cancer Communications

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Introduction Although an association between metabolic dysfunction‐associated fatty liver disease (MAFLD) and cardiovascular disease or overall mortality has been reported, it is unclear whether there is an association between MAFLD and cancer incidence or mortality. We aimed to investigate the differential risk of all‐ and site‐specific cancer incidence and mortality according to MAFLD subgroups categorized by additional etiologies of liver disease. Methods Using the Korean National Health Insurance Service database, we stratified the participants into three groups: (1) single‐etiology MAFLD (S‐MAFLD) or MAFLD of pure metabolic origin; (2) mixed‐etiology MAFLD (M‐MAFLD) or MAFLD with additional etiological factor(s) (i.e., concomitant liver diseases and/or heavy alcohol consumption); and (3) non‐MAFLD. Hepatic steatosis and fibrosis were defined using the fatty liver index and the BARD score, respectively. Cox proportional hazards regression was performed to estimate the risk of cancer events. Results Among the 9,718,182 participants, the prevalence of S‐MAFLD and M‐MAFLD was 29.2% and 6.7%, respectively. During the median 8.3 years of follow‐up, 510,330 (5.3%) individuals were newly diagnosed with cancer, and 122,774 (1.3%) cancer‐related deaths occurred among the entire cohort. Compared with the non‐MAFLD group, the risk of all‐cancer incidence and mortality was slightly higher among patients in the S‐MAFLD group (incidence, adjusted hazard ratio [aHR] = 1.03; 95% confidence interval [CI]: 1.02−1.04; mortality, aHR = 1.06; 95% CI: 1.04−1.08) and highest among patients with M‐MAFLD group (incidence, aHR = 1.31; 95% CI: 1.29−1.32; mortality, aHR = 1.45; 95% CI: 1.42−1.48, respectively). The M‐MAFLD with fibrosis group (BARD score ≥ 2) showed the highest relative risk of all‐cancer incidence (aHR = 1.38, 95% CI = 1.36–1.39), followed by the M‐MAFLD without fibrosis group (aHR = 1.09, 95% CI = 1.06–1.11). Similar trends were observed for cancer‐related mortality. Conclusions MAFLD classification, by applying additional etiologies other than pure metabolic origin, can be used to identify a subgroup of patients with poor cancer‐related outcomes.

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Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States

Cited by 305 publications

References 27 publications

NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

Epidemiology and Clinical Outcomes of Metabolic (Dysfunction)-associated Fatty Liver Disease

Differential risk of 23 site‐specific incident cancers and cancer‐related mortality among patients with metabolic dysfunction‐associated fatty liver disease: a population‐based cohort study with 9.7 million Korean subjects

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