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Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study

Authors
 Hokyou Lee  ;  Yong-Ho Lee  ;  Seung Up Kim  ;  Hyeon Chang Kim 
Citation
 CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol.19(10) : 2138-2147.e10, 2021-10 
Journal Title
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 1542-3565 
Issue Date
2021-10
MeSH
Adult ; Cardiovascular Diseases* / epidemiology ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease* / complications ; Non-alcoholic Fatty Liver Disease* / epidemiology ; Prevalence
Keywords
Cardiovascular Diseases ; Metabolic Dysfunction-Associated Fatty Liver Disease ; Nonalcoholic Fatty Liver Disease ; Prevalence ; Risk Factors
Abstract
Background & aims: An international expert panel proposed a new definition for metabolic dysfunction-associated fatty liver disease (MAFLD) as a name change from nonalcoholic fatty liver disease (NAFLD). The clinical impact of this change on the assessment of cardiovascular disease (CVD) risk is yet unknown. We evaluated the prevalence of fatty liver disease (FLD) and the associated CVD risk using each of these definitions.

Methods: From a nationwide health screening database, we included 9,584,399 participants (48.5% male) aged 40-64 years between 2009 and 2010. Participants were categorized by presence of NAFLD and MAFLD, separately, and by the combination of the 2 definitions-Neither-FLD, NAFLD-only, MAFLD-only, or Both-FLD. The primary outcome was a composite CVD event, including myocardial infarction, ischemic stroke, heart failure, or CVD-related death.

Results: The prevalence of NAFLD and MAFLD was 28.0% and 37.3%, respectively. After excluding those with prior CVD, 8,962,813 participants were followed for a median of 10.1 years. NAFLD and MAFLD were each associated with significantly higher risk for CVD events. When the Neither-FLD group was the reference, multivariable-adjusted hazard ratios (95% confidence interval) for CVD events were 1.09 (1.03-1.15) in the NAFLD-only group, 1.43 (1.41-1.45) in the MAFLD-only group, and 1.56 (1.54-1.58) in the Both-FLD group.

Conclusions: A considerable proportion of middle-aged Korean adults have MAFLD without satisfying the former definition of NAFLD. The change from NAFLD to MAFLD criteria may identify a greater number of individuals with metabolically complicated fatty liver and increased risk for CVD.
Full Text
https://www.sciencedirect.com/science/article/pii/S1542356520317171
DOI
10.1016/j.cgh.2020.12.022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hokyou(이호규) ORCID logo https://orcid.org/0000-0002-5034-8422
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186912
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