Subtypes of MASLD confer distinct clinical trajectories

Abstract

Section snippets

Background and context

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major global health concern, affecting up to one-third of the population.¹ It can progress from simple hepatic steatosis to more severe stages such as steatohepatitis and cirrhosis, and ultimately liver-related mortality, often as a result of hepatic decompensation.¹ Additionally, MASLD is strongly associated with extrahepatic complications, including cardiovascular disease and various malignancies, which further contribute

Objectives, methods, and findings

The primary aim of the study was to identify distinct subtypes of MASLD with similar histological severity but differing biological profiles and associated cardiovascular risk. To achieve this, the authors employed a data-driven clustering approach to classify a cohort of 1,389 bariatric surgery patients from France. The cohort was stratified into clusters based on six clinical variables: age, body mass index, plasma triglycerides, hemoglobin A1c, alanine aminotransferase (ALT), and LDL

Significance of findings

The study by Raverdy et al. advances our understanding of the clinical heterogeneity observed in MASLD. By applying a data-driven clustering approach, the authors identified two distinct subtypes of MASLD – ‘cardiometabolic’ and ‘liver-specific’ – that carry different prognostic implications for liver and cardiovascular disease. Both subtypes are associated with an increased risk of liver disease, but only the ‘cardiometabolic’ subtype is linked to a significantly higher risk of cardiovascular

Declaration of AI-assisted technologies in the writing process

During the preparation of this work the author used GPT-4 in order to proofread the manuscript. After using this tool, the author reviewed and edited the content as needed and takes full responsibility for the content of the publication.

Financial support

Dr. Luukkonen was supported by the Academy of Finland (350545), the Sigrid Jusélius Foundation, the Novo Nordisk Foundation (NNF22OC0074397), the Emil Aaltonen Foundation, the Finnish Medical Foundation, the Wilhelm and Else Stockmann's Foundation and the Early Career Investigator fund of the University of Helsinki.

Conflict of interest

The author of this study declares that they do not have any conflict of interest.Please refer to the accompanying ICMJE disclosure forms for further details.