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

Abstract

Background Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25–30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. Methods and results A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. Conculsions The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research. Supplementary Information The online version contains supplementary material available at 10.1007/s12072-023-10543-8.

Hs-CRP is associated with Heart Failure Hospitalization in Patients with MAFLD and Normal LVEF Undergoing Coronary Angiography

“…Patients with MAFLD often have multiple cardiometabolic disorders leading to myocardial remodeling and diastolic dysfunction over time. [28][29][30] However, these individuals are more likely to develop HFpEF than patients with HF with reduced LVEF (HFrEF). 31,32 Hence, understanding the prevalence of pre-HFpEF and HFpEF among patients with MAFLD is clinically important for promptly identifying individuals at higher risk of developing HF and who may benefit from targeted pharmacotherapies to reduce their HF risk.…”

AutoFibroNet: A deep learning and multi‐photon microscopy‐derived automated network for liver fibrosis quantification in MAFLD

“…1,2 Individuals with MAFLD are at greater risk of liver damage, chronic kidney disease, impaired lung function and cardiovascular disease compared to those without MAFLD. [3][4][5][6][7] The histopathologic spectrum of MAFLD ranges from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), advanced fibrosis and cirrhosis. 8 NASH is typically characterised by histological lobular inflammation and hepatocyte ballooning and is associated with a faster progression of liver fibrosis compared to NAFL.…”

“…Metabolic dysfunction‐associated fatty liver disease (MAFLD), formerly named non‐alcoholic fatty liver disease (NAFLD), has become the most common chronic liver disease, affecting up to ~30% of the world's adult population 1,2 . Individuals with MAFLD are at greater risk of liver damage, chronic kidney disease, impaired lung function and cardiovascular disease compared to those without MAFLD 3–7 . The histopathologic spectrum of MAFLD ranges from non‐alcoholic fatty liver (NAFL) to non‐alcoholic steatohepatitis (NASH), advanced fibrosis and cirrhosis 8 .…”

Object detection: A novel AI technology for the diagnosis of hepatocyte ballooning

“…1 MAFLD has become one of the most prevalent chronic liver diseases worldwide. [6][7][8][9][10][11][12] Up to ~20%-30% of patients with MAFLD can progress to metabolic dysfunction-associated steatohepatitis (MASH, formerly named NASH), [13][14][15][16] developing advanced fibrosis, cirrhosis, 17,18 or hepatocellular carcinoma. [19][20][21] Therefore, early diagnosis of MASH is crucial for controlling the progression of this common metabolic liver disease.…”