MAFLD Predicts the Risk of Cardiovascular Disease Better than NAFLD in Asymptomatic Subjects with Health Check-Ups (original) (raw)

Abstract

Background and Aim

Metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to compensate for the conventional concept of nonalcoholic fatty liver disease (NAFLD). We investigated the superiority of MAFLD versus NAFLD in predicting the risk of atherosclerotic cardiovascular disease (ASCVD).

Methods

A total of 2,144 subjects without a history of ASCVD, who underwent a comprehensive medical health check-up, were selected for the study. The associations between fatty liver status and coronary risk surrogates, such as coronary artery calcium score (CACS), coronary artery disease, quantitative stenosis grade, and 10-year ASCVD risk, were analyzed.

Results

MAFLD and NAFLD were identified in 995 (46.4%) and 891 (41.6%) subjects, respectively. Subjects with MAFLD or NAFLD were more likely to be male and had a significantly higher prevalence of central obesity, obesity, hypertension, diabetes, and dyslipidemia (all, p < 0.05) than their counterparts. In terms of coronary risk surrogates, the MAFLD or NAFLD population had a significantly higher proportion of subjects with CACS > 100, coronary artery disease, higher grade of coronary artery stenosis, and higher 10-year ASCVD risk (all, p < 0.05) than their counterparts. Multivariable logistic regression models showed an independent association between MAFLD/NAFLD and coronary risk surrogates (all, p < 0.05). However, NAFLD only, defined as ‘NAFLD, but not MAFLD,’ was not associated with an increased coronary risk, compared to MAFLD.

Conclusions

Although both MAFLD and NAFLD discriminated different ASCVD risks, MAFLD predicted the risk of ASCVD better than NAFLD in asymptomatic subjects who underwent medical health check-ups.

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Acknowledgments

This study was supported by the Technology Innovation Program (20013712) funded by the Ministry of Trade, Industry and Energy (MOTIE, Korea) and by Basic Science Research Program through the NRF of Korea funded by the Ministry of Education (NRF-2017R1D1A1B03034053). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Author notes

  1. Hyoeun Kim and Chan Joo Lee equally contributed to this work. Byoung Kwon Lee, Seung Up Kim, and Jung Il Lee equally contributed to this work.

Authors and Affiliations

  1. Department of Health Promotion, Severance Health Check-Up, Severance Hospital, Yonsei University Health System, Seoul, Korea
    Hyoeun Kim
  2. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
    Chan Joo Lee
  3. Department of Internal Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea
    Sang Hoon Ahn, Kwan Sik Lee, Seung Up Kim & Jung Il Lee
  4. Yonsei Liver Center, Severance Hospital, Seoul, Korea
    Sang Hoon Ahn & Seung Up Kim
  5. Division of Gastroenterology and Hepatology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
    Kwan Sik Lee & Jung Il Lee
  6. Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
    Byoung Kwon Lee
  7. Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, Seoul, Korea
    Su Jung Baik

Authors

  1. Hyoeun Kim
  2. Chan Joo Lee
  3. Sang Hoon Ahn
  4. Kwan Sik Lee
  5. Byoung Kwon Lee
  6. Su Jung Baik
  7. Seung Up Kim
  8. Jung Il Lee

Contributions

HK and CJL involved in data acquisition, analysis, and interpretation; manuscript drafting; and statistical analysis; HK, CJL, BKL, SUK, and JIL took part in data acquisition and interpretation; SHA, KSL, SJB involved in data interpretation; SUK and JIL took part in manuscript drafting; BKL, SUK, and JIL involved in study concept and design, data analysis, and interpretation; manuscript drafting; and study supervision.

Corresponding author

Correspondence toSeung Up Kim.

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Conflict of interest

Chan Joo Lee has received lecture honoraria from Novartis, Hanmi Pharmaceutical, Yuhan, Boryung Pharmaceutical, and Daiichi Sankyo. He has also received a research grant from Boryung Pharmaceutical; Seung Up Kim has served as an advisory committee member Gilead Sciences, GSK, Bayer, and Eisai. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, Abbive, EchoSens, MSD, and Bristol-Myers Squibb. He has also received a research grant from Abbive and Bristol-Myers Squibb. The other authors declare that they have no competing interests.

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Kim, H., Lee, C.J., Ahn, S.H. et al. MAFLD Predicts the Risk of Cardiovascular Disease Better than NAFLD in Asymptomatic Subjects with Health Check-Ups.Dig Dis Sci 67, 4919–4928 (2022). https://doi.org/10.1007/s10620-022-07508-6

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