MAFLD better predicts the progression of atherosclerotic cardiovascular risk than NAFLD: Generalized estimating equation approach

Hepatology Research, Journal Year: 2021, Volume and Issue: 51(11), P. 1115 - 1128

Published: June 15, 2021

Metabolic associated fatty liver disease (MAFLD) partly overlaps with non-alcoholic (NAFLD). Thus, using a generalized estimating equation (GEE) approach, we aimed to investigate the difference in worsening of atherosclerotic cardiovascular (ASCVD) risk between patients MAFLD and NAFLD. We also investigated factors related two groups.We enrolled 2306 subjects (MAFLD 80.7%, NAFLD 63.4%). Subjects MAFLD/NAFLD were sub-classified into three groups: no metabolic dysfunction (non-Met NAFLD), overlapping, moderate alcohol consumption (mod-Alc MAFLD). ASCVD was estimated by non-invasive tests, including Suita score. An event defined as these scores from low-risk high-risk group. Independent for analyzed Cox regression analysis GEE.In analysis, (HR 1.08, 95% CI 1.02-1.15, p = 0.014) (20-39 g/day; HR 1.73, 1.26-2.36, 0.001) independently In subanalysis, incidence significantly lower non-Met than overlapping group 0.70, 0.50-0.98, 0.042). However, significant observed mod-Alc 1.19, 0.89-1.58, 0.235).The GEE approach demonstrates that better identifies Moreover, superiority over due presence rather consumption.

Language: Английский

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Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases

International Journal of Molecular Sciences, Journal Year: 2021, Volume and Issue: 22(21), P. 11629 - 11629

Published: Oct. 27, 2021

Obesity is now a worldwide epidemic ensuing an increase in comorbidities' prevalence, such as insulin resistance, type 2 diabetes (T2D), metabolic dysfunction-associated fatty liver disease (MAFLD), nonalcoholic steatohepatitis (NASH), hypertension, cardiovascular (CVD), autoimmune diseases, and some cancers, CVD being one of the main causes death world. Several studies provide evidence for association between MAFLD atherosclerosis cardio-metabolic disorders, including CVDs coronary heart stroke. Therefore, combination MAFLD/NASH associated with vascular risk progression, but underlying mechanisms linking are still under investigation. may probably be involved, hepatic/systemic atherogenic dyslipidemia, well pro-atherogenic, pro-coagulant, pro-inflammatory mediators released from steatotic/inflamed liver. strongly which involved its pathogenesis progression to NASH. Insulin resistance major factor subjects without diabetes. However, T2D has been considered most common link CVD. This review summarizes obesity MAFLD, NASH, CVD, considering pathophysiological molecular these diseases. We also discuss NASH development structural functional cardiac alterations, pharmacological strategies treat prevention.

Language: Английский

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Association of MAFLD With Diabetes, Chronic Kidney Disease, and Cardiovascular Disease: A 4.6-Year Cohort Study in China

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2021, Volume and Issue: 107(1), P. 88 - 97

Published: Sept. 11, 2021

Abstract Context In 2020, the terminology of metabolic dysfunction–associated fatty liver disease (MAFLD) was proposed to replace nonalcoholic (NAFLD). Objectives This work aimed investigate prevalence and incidence MAFLD evaluate its effects on incident extrahepatic diseases. Methods A total 6873 individuals, with a 4.6-year follow-up, were included in this study. Associations NAFLD diabetes, chronic kidney (CKD), cardiovascular (CVD) examined using logistic regression Cox proportional hazards models. Results The 40.3% (95% CI, 39.2%-41.5%) 46.7% 45.6%-47.9%), respectively. Additionally, 321 (4.7%) 156 (2.3%) participants had excessive alcohol consumption hepatitis B virus (HBV) infection. During follow-up period, 22.7% 21.3%-24.0%) 27.0% 25.5%-28.4%). associated higher risks diabetes (risk ratio [RR] 2.08; 95% 1.72-2.52), CKD (RR 1.64; 1.39-1.94), CVD (hazard 1.44; 1.15-1.81). Similar associations for observed. Furthermore, subgroups 2.49; 1.64-3.78) HBV infection 1.98; 1.11-3.52) diabetes. Conclusion change from did not greatly affect CKD, CVD. further identified those patients metabolically combined infection, who increased compared non–fatty liver.

Language: Английский

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Mechanisms of Non-Alcoholic Fatty Liver Disease in the Metabolic Syndrome. A Narrative Review

Antioxidants, Journal Year: 2021, Volume and Issue: 10(2), P. 270 - 270

Published: Feb. 10, 2021

Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are two different entities sharing common clinical physio-pathological features, with insulin resistance (IR) as the most relevant. Large evidence leads to consider it a risk factor for cardiovascular disease, regardless of age, sex, smoking habit, cholesterolemia, other elements MS. Therapeutic strategies remain still unclear, but lifestyle modifications (diet, physical exercise, weight loss) determine an improvement in IR, MS, both histologic picture. NAFLD IR bidirectionally correlated and, consequently, development pre-diabetes diabetes is direct consequence at extrahepatic level. In turn, type 2 well-known multiorgan damage, including involvement system, kidney peripheral nervous system. The increased MS incidence worldwide, above all due changes diet lifestyle, associated equally significant increase NAFLD, subsequent rise morbidity mortality metabolic, hepatic diseases. Therefore, slowdown "bad company" constituted by consequent indirect costs, represents one main challenges National Health Systems.

Language: Английский

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Metabolic-associated Fatty Liver Disease (MAFLD): A Multi-systemic Disease Beyond the Liver

Journal of Clinical and Translational Hepatology, Journal Year: 2021, Volume and Issue: 10(2), P. 329 - 338

Published: Oct. 19, 2021

Nonalcoholic fatty liver disease (NAFLD) is a multisystemic clinical condition that presents with wide spectrum of extrahepatic manifestations, such as obesity, type 2 diabetes mellitus, metabolic syndrome, cardiovascular diseases, chronic kidney disease, malignancies, cognitive disorders, and polycystic ovarian syndrome. Among NAFLD patients, the most common mortality etiology followed by liver-related complications. Furthermore, severity diseases parallel to NAFLD. In practice, awareness associations concomitant major importance for initiating prompt timely screening multidisciplinary management spectrum. 2020, consensus from 22 countries redefined (dysfunction)-associated (MAFLD), which resulted in redefinition corresponding population. Although patients diagnosed MAFLD mostly overlap, populations are not identical. this review, we compared key between MAFLD.

Language: Английский

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

Cardiovascular Diabetology, Journal Year: 2022, Volume and Issue: 21(1)

Published: Dec. 3, 2022

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

Language: Английский

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

Hepatology International, Journal Year: 2023, Volume and Issue: 17(4), P. 773 - 791

Published: May 19, 2023

Language: Английский

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Metabolic dysfunction-associated steatotic liver disease and risk of cardiovascular disease

Gut, Journal Year: 2023, Volume and Issue: unknown, P. gutjnl - 331003

Published: Oct. 31, 2023

Objective We explored clinical implications of the new definition metabolic dysfunction-associated steatotic liver disease (MASLD) by assessing its prevalence and associated cardiovascular (CVD) risk. Design From nationwide health screening data, we identified 9 775 066 adults aged 20–79 who underwent examination in 2009. Participants were categorised into four mutually exclusive groups: (1) MASLD; (2) MASLD with increased alcohol intake (MetALD); (3) other combined aetiology (the three collectively referred to as MASLD/related (SLD)); (4) no SLD. SLD was determined fatty index ≥30. The primary outcome CVD event, defined a composite myocardial infarction, ischaemic stroke, heart failure or death. Results MASLD, MetALD 27.5%, 4.4% 1.5%, respectively. A total 8 808 494 participants without prior followed up for median 12.3 years, during which 272 863 events occurred. cumulative incidence multivariable-adjusted risk higher than those (HR 1.38 (95% CI 1.37 1.39)). Multivariable-adjusted HR CI) 1.39 (1.38 1.40) 1.28 (1.26 1.30) 1.30 1.34) compared absence any these conditions. also non-alcoholic respective condition. Conclusion Over one-third Korean have bear high

Language: Английский

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Critical appraisal of metabolic dysfunction-associated steatotic liver disease: Implication of Janus-faced modernity

Clinical and Molecular Hepatology, Journal Year: 2023, Volume and Issue: 29(4), P. 831 - 843

Published: Aug. 27, 2023

The existing term non-alcoholic fatty liver disease (NAFLD) has raised substantial concerns due to its inherent disadvantages of using exclusionary diagnostic criteria and the stigmatizing word 'fatty.' Three pan-national associations set out explore a new nomenclature replace both NAFLD suggested alternative, metabolic (dysfunction)-associated (MAFLD). They surveyed if change in and/or definition is favored which best communicates characteristics increases awareness. In lieu NAFLD/MAFLD, dysfunction-associated steatotic (MASLD) been chosen, an umbrella term, (SLD), encompassing whole spectrum disease, proposed. It that cardiometabolic risk factors should be considered when categorizing SLD patients. Furthermore, subcategory, MASLD with increased alcohol intake (MetALD), casts light on neglected group patients moderate or more consumption. importance dysfunction was acknowledged this nomenclature, but precise contribution consumption development progression remains unclear. Herein, we review hepatologists' endocrinologists' perspectives along possible impact clinical practice. Although it premature predict settlement may help build evidence for soft landing future.

Language: Английский

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An international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease

HepatoBiliary Surgery and Nutrition, Journal Year: 2023, Volume and Issue: 12(3), P. 386 - 403

Published: Feb. 24, 2023

With the rising global prevalence of fatty liver disease related to metabolic dysfunction, association this common condition with chronic kidney (CKD) has become increasingly evident. In 2020, more inclusive term dysfunction-associated (MAFLD) was proposed replace non-alcoholic (NAFLD). The observed between MAFLD and CKD our understanding that can be a consequence underlying dysfunction support notion individuals are at higher risk having developing compared those without MAFLD. However, date, there is no appropriate guidance on in Furthermore, been little attention paid link Nephrology community.Using Delphi-based approach, multidisciplinary panel 50 international experts from 26 countries reached consensus some open research questions regarding CKD.This statement provided epidemiology, mechanisms, management treatment CKD, as well relationship severity which establish framework for early prevention these two interconnected diseases.

Language: Английский

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