Cardiometabolic criteria as predictors and treatment targets of liver‐related events and cardiovascular events in metabolic dysfunction‐associated steatotic liver disease

作者：Nobuharu Tamaki, Takefumi Kimura, Shun‐ichi Wakabayashi, Takeji Umemura, Namiki Izumi, Rohit Seth Loomba, Masayuki Kurosaki · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2024 · DOI：10.1111/apt.18205 · 被引用次数：30 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND: The diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) requires at least one of five cardiometabolic criteria. It is unclear whether these criteria can be used as predictors and treatment targets for complications including liver-related events and major adverse cardiovascular events (MACE). AIMS: To investigate the relationship between cardiometabolic criteria and complications. METHODS: We conducted a nationwide, population-based study of 979,352 patients with MASLD. We investigated relationships between a number of criteria at baseline and liver-related events or MACE risks. In a separate longitudinal analysis, we included patients with five criteria at baseline and investigated the relationship between improving the criteria and the incidence of complications after 1 year. RESULTS: The cumulative incidence of MACE, but not liver-related events, increased with increasing baseline cardiometabolic criteria. In the longitudinal study, multivariable analysis using patients with five criteria (no improvement) as the reference, adjusted hazard ratios (95% confidence interval) of MACE in patients with 4, 3, 2, and 0-1 criteria (1 to 4-5 criteria improvement) were 0.55 (0.52-0.58, p < 0.001), 0.20 (0.17-0.22, p < 0.001), 0.13 (0.11-0.16, p < 0.001), and 0.06 (0.02-0.3, p < 0.001), respectively. The risk of MACE decreased as the cardiometabolic criteria improved. There was no significant association between improvement of the criteria and live...