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Mortality in metabolic dysfunction-associated steatotic liver disease: A nationwide population-based cohort study

Authors
 Eugene Han  ;  Byung-Wan Lee  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Sang Hoon Ahn  ;  Yong-Ho Lee  ;  Seung Up Kim 
Citation
 METABOLISM-CLINICAL AND EXPERIMENTAL, Vol.152 : 155789, 2024-03 
Journal Title
METABOLISM-CLINICAL AND EXPERIMENTAL
ISSN
 0026-0495 
Issue Date
2024-03
MeSH
Cohort Studies ; Diabetes Mellitus* ; Female ; Humans ; Liver Cirrhosis / complications ; Liver Cirrhosis / epidemiology ; Male ; Metabolic Diseases* / complications ; Metabolic Diseases* / epidemiology ; Middle Aged ; Non-alcoholic Fatty Liver Disease* ; Nutrition Surveys
Keywords
Diabetes ; Fatty liver disease ; Liver fibrosis ; Mortality
Abstract
Background: A new fatty liver disease nomenclature, steatotic liver disease (SLD) has been proposed; however, there are no data on clinical outcomes. We investigated the impact of SLD with metabolic dysfunction (MD; SLD-MD) on all-cause mortality. Methods: We evaluated nationally representative participants aged ≥19 years using data from the Korea National Health and Nutrition Examination Survey 2007–2015 and their linked death data through 2019. The presence of fatty liver disease was assessed by liver fat score, fatty liver index and significant liver fibrosis was evaluated by the Fibrosis-4 Index, and fibrosis score. SLD-MD was categorized into three groups: metabolic dysfunction-associated steatotic liver disease (MASLD); metabolic alcoholic liver disease (MetALD); and SLD with other combination etiologies. Results: Among 26734 individuals (11561 men and 15173 women, mean age 48.8 years), 1833 (6.9 %) died during a mean follow-up period of 110.6 ± 33.9 months. Mortality risk was significantly higher in individuals with SLD-MD (hazard ratio [HR] = 1.35) than in those without (P < 0.001). Among the three groups, MASLD (HR = 1.32) and SLD with other combination etiologies (HR = 2.06) independently increased mortality risk (all P < 0.001). When individuals with SLD-MD had significant liver fibrosis or diabetes, mortality risk increased further (HR = 1.68 and 1.85, respectively; all P < 0.001). SLD-MD with both significant liver fibrosis and diabetes showed the highest mortality risk (HR = 2.29, P < 0.001). When applied fatty liver index and fibrosis score, similar results were observed. Conclusions: SLD-MD is associated with a higher mortality risk. When SLD-MD was combined with significant liver fibrosis or diabetes, the mortality risk became much higher. Treatment strategies to reduce fibrotic burden and improve glycemic control in individuals with MASLD are needed. © 2024 Elsevier Inc.
Full Text
https://www.sciencedirect.com/science/article/pii/S0026049524000155
DOI
10.1016/j.metabol.2024.155789
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199206
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