MASLD/MetALD and mortality in individuals with any cardio-metabolic risk factor: A population-based study with 26.7 years of follow-up.

IF 12.9 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatology Pub Date : 2025-01-01 Epub Date: 2024-05-13 DOI:10.1097/HEP.0000000000000925
Minsun Kwak, Hyun-Seok Kim, Zhenghui Gordon Jiang, Yee Hui Yeo, Hirsh D Trivedi, Mazen Noureddin, Ju Dong Yang
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Abstract

Background and aims: A new term, metabolic dysfunction-associated steatotic liver disease (MASLD), has been proposed by a multi-society expert panel. However, it remains unclear whether hepatic steatosis per se in MASLD contributes to an increased risk of mortality in individuals with any cardio-metabolic risk factor (CMRF), which is also a significant risk factor for increased mortality. This study aimed to compare all-cause and cause-specific mortality between the "MASLD/MetALD" and "no steatotic liver disease (SLD)" groups in individuals with any CMRF.

Approach and results: A population-based cohort study was conducted using 10,750 participants of the Third National Health and Nutrition Examination Survey. All-cause and cause-specific (cardiovascular, cancer, diabetes, and liver) mortality risks were compared between the "MASLD," "MetALD," and "no SLD" groups using the Cox proportional hazards model with complex survey design weights, adjusted for confounders. Over 26 years, the "MASLD" group did not show significantly increased all-cause (adjusted HR 1.04[95% CI: 0.95-1.14], p = 0.413), cardiovascular (0.88 [0.75-1.04], p = 0.139), or cancer (1.06[0.84-1.33], p = 0.635) mortality risk compared to the "no SLD" group in individuals with any CMRF. The MetALD group was associated with increased all-cause (1.41 [1.05-1.89], p = 0.022), cancer (2.35 [1.33-4.16], p = 0.004), and liver (15.04 [2.96-76.35], p = 0.002) mortality risk compared with the no SLD group. This trend was more pronounced in the MetALD group with advanced fibrosis assessed by Fibrosis-4 (FIB-4).

Conclusions: In individuals with CMRF, the presence of steatotic liver disease (MASLD) alone did not increase the risk of mortality, except in cases with more alcohol consumption (MetALD). Therefore controlling metabolic risk factors and reducing alcohol consumption in people with MASLD or MetALD will be crucial steps to improve long-term health outcomes.

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MASLD/MetALD与具有任何心血管代谢风险因素者的死亡率:一项为期26.7年的人群跟踪研究。
背景目的:多学会专家小组提出了一个新名词--代谢功能障碍相关性脂肪性肝病(MASLD)。然而,目前仍不清楚 MASLD 中的肝脏脂肪变性本身是否会导致具有任何心血管代谢风险因素(CMRF)的个体的死亡风险增加,而这些因素也是导致死亡率增加的重要风险因素。本研究旨在比较患有任何CMRF的患者中 "MASLD/MetALD "组和 "无脂肪性肝病(SLD)"组的全因死亡率和特定病因死亡率:利用 10,750 名 NHANES III 参与者开展了一项基于人群的队列研究。采用带有复杂调查设计权重的 Cox 比例危险模型,并对混杂因素进行调整,比较了 "MASLD "组、"MetALD "组和 "无 SLD "组之间的全因和特定原因(心血管、癌症、糖尿病和肝脏)死亡风险。与 "无 SLD "组相比,在 26 年中,与任何 CMRF 的个体相比,"MASLD "组的全因(调整后危险比 1.04[95% 置信区间 0.95-1.14],p=0.413)、心血管(0.88[0.75-1.04],p=0.139)或癌症(1.06[0.84-1.33],p=0.635)死亡风险没有明显增加。与无 SLD 组相比,MetALD 组的全因(1.41[1.05-1.89],p=0.022)、癌症(2.35[1.33-4.16],p=0.004)和肝脏(15.04[2.96-76.35],p=0.002)死亡风险增加。这一趋势在经 FIB-4 评估为纤维化晚期的 MetALD 组更为明显:结论:在 CMRF 患者中,除了饮酒较多的病例(MetALD)外,仅存在脂肪肝(MASLD)并不会增加死亡风险。因此,控制代谢风险因素和减少MASLD或MetALD患者的饮酒量将是改善长期健康状况的关键步骤。
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来源期刊
Hepatology
Hepatology 医学-胃肠肝病学
CiteScore
27.50
自引率
3.70%
发文量
609
审稿时长
1 months
期刊介绍: HEPATOLOGY is recognized as the leading publication in the field of liver disease. It features original, peer-reviewed articles covering various aspects of liver structure, function, and disease. The journal's distinguished Editorial Board carefully selects the best articles each month, focusing on topics including immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases, liver cancer, and drug metabolism.
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