Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease

Abstract

Background and Aims:We compared lung function parameters in nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD), and examined the association between lung function parameters and fibrosis severity in MAFLD. Meth-ods: In this cross-sectional study, we randomly recruited 2,543 middle-aged individuals from 25 communities across four cities in China during 2016 and 2020. All participants received a health check-up including measurement of anthropometric parameters, biochemical variables, liver ultrasonography, and spirometry. The severity of liver disease was assessed by the fibrosis (FIB)-4 score. Results: The prevalence of MAFLD was 20.4% (n=519) and that of NAFLD was 18.4% (n=469). After adjusting for age, sex, adiposity measures, smoking status, and significant alcohol intake, subjects with MAFLD had a significantly lower predicted forced vital capacity (FVC, 88.27±17.60% vs. 90.82±16.85%, p<0.05) and lower 1 s forced expiratory volume (FEV 1 , 79.89±17.34 vs. 83.02±16.66%, p<0.05) than those with NAFLD. MAFLD with an increased FIB-4 score was significantly associated with decreased lung function. For each 1-point increase in FIB-4, FVC was diminished by 0.507 (95% CI: −0.840, −0.173, p=0.003), and FEV 1 was diminished by 0.439 (95% CI: −0.739, −0.140, p=0.004). The results remained unchanged when the statistical analyses was performed separately for men and women. Conclusions: MAFLD was significantly associated with a greater impairment of lung function parameters than NAFLD.

Old and new classes of glucose-lowering agents as treatments for non-alcoholic fatty liver disease: A narrative review

“…the leading cause of death in people with NAFLD), certain types of extra-hepatic cancers, chronic pulmonary and renal diseases. [23][24][25][26][27][28] Despite intensive research, there is still no drug to date that has been approved for the treatment of NAFLD or NASH. Lifestyle modifications, which include hypocaloric diet and physical activity to achieve weight loss, are the cornerstone of treatment for NAFLD and NASH.…”

Effect of cofactors on NAFLD/NASH and MAFLD. A paradigm illustrating the pathomechanics of organ dysfunction

“…However, these do not necessarily need to be ruled out and reported in MAFLD diagnosis. MAFLD, on the other hand, probably offers the advantage of more accurately identifying the risk of target organ dysfunction, namely, progressive liver disease [ 120 ] , diabetes and chronic kidney disease [ 121 ] , atherosclerosis [ 122 ] , more severely impaired lung function [ 123 ] , colon cancer [ 124 ] , both intrahepatic and extrahepatic events [ 125 ] , and mortality [ 126 ] , although the last outcome is controversial [ 127 ] .…”

Epidemiology, natural history, and diagnosis of metabolic dysfunction-associated fatty liver disease: a comparative review with nonalcoholic fatty liver disease

“…There is also evidence indicating that the extent of lung impairment is higher in MAFLD than in NAFLD. On analyzing 2543 middle-aged individuals recruited from 25 communities across four cities in China, Miao et al 52 found that patients with MAFLD were characterized by significantly lower forced vital capacity (88.27 ± 17.60% versus 90.82 ± 16.85%, p < 0.05) and one second forced expiratory volume (79.89 ± 17.34 versus 83.02 ± 16.66%, p < 0.05) than those with NAFLD.…”

“…51 There is also evidence indicating that the extent of lung impairment is higher in MAFLD than in NAFLD. On analyzing 2543 middle-aged individuals recruited from 25 communities across four cities in China, Miao et al 52 Finally, colorectal malignancies are prevalent in patients with MAFLD. 53 Interestingly, their burden has been associated with the severity of both MAFLD and NAFLD.…”