Long-term clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease: a single-centre prospective cohort study with baseline liver biopsy - PubMed (original) (raw)

Long-term clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease: a single-centre prospective cohort study with baseline liver biopsy

Wah-Loong Chan et al. Hepatol Int. 2023 Aug.

Abstract

Background: There are limited data on the long-term adverse clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods: This is a single-centre prospective study of a well-characterized cohort of MAFLD patients who underwent liver biopsy and followed every 6-12 months for adverse clinical outcomes.

Results: The data for 202 patients were analyzed [median age 55.0 (48.0-61.3) years old; male, 47.5%; obese, 88.6%; diabetes mellitus, 71.3%; steatohepatitis, 76.7%; advanced fibrosis, 27.2%]. The median follow-up interval was 7 (4-8) years. The cumulative incidence of liver-related events, cardiovascular events, malignancy and mortality was 0.43, 2.03, 0.60 and 0.60 per 100 person-years of follow-up, respectively. Liver-related events were only seen in patient with advanced fibrosis at 9.1% vs 0% in patient without advanced liver fibrosis (p < 0.001). The cumulative incidence of liver-related events among patients with advanced fibrosis was 1.67 per 100 person-years of follow-up. When further stratified to bridging fibrosis and cirrhosis, the cumulative incidence of liver-related events was 1.47 and 3.85 per 100 person-years of follow-up, respectively. Advanced fibrosis was not significantly associated with cardiovascular events, malignancy or mortality. The cumulative incidence of liver-related events, cardiovascular events, malignancy and mortality were not significantly different between patients with and without steatohepatitis and between obese and non-obese patients. However, liver-related events were only seen among obese patients.

Conclusion: Overall, the cumulative incidence of liver-related event is low in patients with MAFLD, but it is much higher among those with advanced fibrosis. However, there is a relatively high cumulative incidence of cardiovascular event among patients with MAFLD.

Keywords: Cardiovascular event; Liver-related event; MAFLD; NAFLD; Non-alcoholic fatty liver disease.

© 2023. Asian Pacific Association for the Study of the Liver.

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Conflict of interest statement

WKC has served as a consultant or advisory board member for Roche, Abbvie, Boehringer Ingelheim and Novo Nordisk; and a speaker for Viatris and Hisky Medical. The other authors have no conflict of interest to declare.

Figures

Fig. 1

Fig. 1

Study flowchart

Fig. 2

Fig. 2

Kaplan–Meier curves showing comparison of outcome events, namely a liver-related events, b cardiovascular events, c malignancy, and d mortality between MAFLD patients with and without steatohepatitis (━━━, with steatohepatitis; - - - -, without steatohepatitis)

Fig. 3

Fig. 3

Kaplan–Meier curves showing comparison of outcome events, namely a liver-related events, b cardiovascular events, c malignancy, and d mortality between MAFLD patients with and without advanced liver fibrosis (━━━, with advanced fibrosis; - - - -, without advanced fibrosis)

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