The progression and regression of metabolic dysfunction-associated fatty liver disease are associated with the development of subclinical atherosclerosis: A prospective analysis

Liu, Shanshan; Wang, Jialu; Wu, Shujing; Niu, Jingya; Zheng, Ruizhi; Bie, Lizhan; Xin, Zhuojun; Wang, Shuangyuan; Lin, Hong; Zhao, Zhiyun; Wang, Tiange; Xu, Min; Lu, Jieli; Chen, Yuhong; Xu, Yawei; Wang, Weiqing; Ning, Guang; Bi, Yufang; Li, Mian; Xu, Yu

doi:10.1016/j.metabol.2021.154779

Cited by 31 publications

(29 citation statements)

References 32 publications

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“…This bene cial effect was not in uenced by metabolic medications and more likely to be attributed to lifestyle modi cation, indicating its cornerstone position in the treatment of fatty liver disease. Furthermore, ndings from our previous research manifested that baseline MAFLD participants with low probability of brosis regressing to non-MAFLD at follow-up decreased the risk of elevated baPWV by 43.1% [23]. Findings may need to be veri ed in a larger-scale and longer-term cohort, nevertheless, our study provided the evidence to some extent that recommendations for the primary cardiometabolic risk prevention should not overlook the importance of maintaining MH status regardless of fatty liver status.…”

Section: Discussionmentioning

confidence: 64%

“…Since changing term from NAFLD to MAFLD, fatty liver disease associated with metabolic abnormalities is of growingly public health concern. Previous evidence has been explicit that NAFLD or the new term MAFLD was an independent risk factor for both clinical cardiovascular events [19][20][21] and subclinical atherosclerotic lesion [22][23]. Results in the prior half of the current study were generally in line with previous cohort ndings, supporting the notion that fatty liver disease combining with metabolic abnormalities synergistically contributed to the increased risk of subclinical atherosclerosis, re ected by artery stiffness (elevated baPWV and PP) and endothelial dysfunction (albuminuria).…”

Section: Discussionmentioning

confidence: 99%

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Risk of subclinical atherosclerosis across metabolic transition in individuals with or without fatty liver disease: a prospective cohort study

Xin

Huang

Cao

et al. 2022

Preprint

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Background Metabolic dysfunction is a major determinant in the progression of fatty liver disease. It is pivotal to evaluate the metabolic status and subsequent transition in fatty liver population and to identify the risk of subclinical atherosclerosis. Methods The prospective cohort study included 6260 Chinese community residents during 2010–2015. Fatty liver was determined as hepatic steatosis (HS) by ultrasonography. Metabolic unhealthy (MU) status was defined as having diabetes and/or ≥ 2 metabolic risk factors. Participants were categorized into 4 groups according to the combination of metabolic healthy (MH)/MU and fatty liver status (MHNHS, MUNHS, MHHS and MUHS). Subclinical atherosclerosis was assessed by elevated brachial-ankle pulse wave velocity, pulse pressure and/or albuminuria. Results 31.3% of the participants had fatty liver disease and 76.9% were in MU status. During a 4.3-year follow-up, 24.2% of participants developed composite subclinical atherosclerosis. Multivariable adjusted odds ratios for composite subclinical atherosclerosis risk were (1.66 [1.30–2.13]) in MUNHS group and (2.57 [1.90–3.48]) in MUHS group. It seemed that participants with fatty liver disease were more prone to be remained in MU status (90.7% vs.50.8%) and less likely to regress to MH status (4.0% vs. 8.9%). Fatty liver participants progressed to (3.11 [1.23–7.92]) or maintained MU status (4.87 [3.25–7.31]) significantly impelled the development of the composite risk, while regressing to MH status (0.15 [0.04–0.64]) were more intended to mitigate the risk. Conclusions The current study emphasized the importance of assessing metabolic status and its dynamic changes, especially in the fatty liver population. Regressing from MU to MH status not only benefited the systematic metabolic profile but also ameliorated future cardiometabolic complications.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Risk of subclinical atherosclerosis across metabolic transition in individuals with or without fatty liver disease: a prospective cohort study

Xin

Huang

Cao

et al. 2022

Preprint

Self Cite

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“…In addition, a study enrolled more than 8,000 Chinese individuals with an average follow-up of 4 years and assessed subclinical atherosclerosis by ultrasonic determination of carotid intima-media thickness and brachial-ankle pulse wave velocity. The results suggested that individuals with MAFLD remission had a much lower risk of subclinical atherosclerosis than those without MAFLD remission [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Neck Circumference Predicts the Occurrence and Remission of Metabolic Associated Fatty Liver Disease: A Longitudinal Study of Community-Dwelling Population

Cao¹,

Xu²,

Shen³

et al. 2022

Ann Nutr Metab

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Aim: Neck circumference (NC), a proxy for upper-body subcutaneous fat, is closely related to metabolic dysfunction, independent of other obesity indices. The purpose of this study was to explore the relationship between NC and the incidence and remission of metabolic associated fatty liver disease (MAFLD), a novel concept proposed by an international consensus panel in 2020 through a community-based longitudinal cohort. Methods: This study included 1549 community participants and was conducted from 2013 to 2016. MAFLD was diagnosed using the International Expert Consensus (2020) criteria. All participants underwent NC measurement and biochemical measurements. Elevated NC was defined as NC ≥38.5 cm in men and NC ≥34.5 cm in women. Results: A total of 1549 subjects (638 men and 911 women), with an average age of 59.6 ± 7.3 years, were included. During a mean follow-up of 2.1 years, MAFLD occurred in 146 of the 870 participants without baseline MAFLD and was resolved in 225 of the 679 participants with baseline MAFLD. After adjusting for confounding factors such as age, sex, body mass index, waist circumference, fasting plasma glucose and liver enzyme levels, multivariable logistic regression showed that higher NC at baseline was positively correlated with MAFLD occurrence (OR 1.96, 95% confidence interval: 1.21–3.31; P=0.003) and negatively correlated with MAFLD remission (OR 0.57, 95% confidence interval: 0.40–0.80; P<0.001). Conclusion: A higher NC is associated with an increased risk of MAFLD occurrence and a reduced probability of MAFLD remission, making NC measurement a potential predictor in MALFD management.

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“…Furthermore, patients with concomitant MAFLD and viral hepatitis, but not NAFLD and viral hepatitis, had a significantly increased cardiovascular risk as assessed by cardiovascular disease risk estimator and atherogenic indices [100] . Tsutsumi et al [101] recently used a generalized estimating equation approach to investigate the difference in atherosclerotic cardiovascular disease (ASCVD) risk between patients with MAFLD and NAFLD. Using this approach, they found that MAFLD better identifies patients with higher ASCVD risk, and this was due to the presence of metabolic dysfunction rather than moderate alcohol consumption.…”

Section: Differences Between Nafld and Mafldmentioning

confidence: 99%

Risk of cardio-nephro-metabolic disease from NAFLD to MAFLD: fact or fiction?

Hassouneh¹,

Siddiqui²,

Bhati³

2021

MTOD

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Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common etiology for chronic liver disease. Despite this, our understanding of this illness is lacking. The previous paradigm is that central adiposity, hyperlipidemia, hypertension, and insulin resistance, also known as metabolic syndrome, lead to NAFLD, and this relationship is unidirectional. However, recent evidence clearly shows that the clinical burden of this illness extends well beyond liver-related morbidity and mortality and is associated with multiple extrahepatic complications, particularly metabolic consequences. Due to this, the professional consensus has proposed using the term metabolic associated fatty liver disease (MAFLD) to more accurately reflect pathogenesis and help in patient stratification for management. This review discusses the shared pathophysiological mechanisms that link these diseases and how this can be leveraged to prevent these complications in individuals with NAFLD/MAFLD.

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The progression and regression of metabolic dysfunction-associated fatty liver disease are associated with the development of subclinical atherosclerosis: A prospective analysis

Cited by 31 publications

References 32 publications

Risk of subclinical atherosclerosis across metabolic transition in individuals with or without fatty liver disease: a prospective cohort study

Risk of subclinical atherosclerosis across metabolic transition in individuals with or without fatty liver disease: a prospective cohort study

Neck Circumference Predicts the Occurrence and Remission of Metabolic Associated Fatty Liver Disease: A Longitudinal Study of Community-Dwelling Population

Risk of cardio-nephro-metabolic disease from NAFLD to MAFLD: fact or fiction?

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