Steatotic liver disease as a risk enhancer in the presence of metabolic syndrome

作者：Guyu Zeng, Peizhi Wang, Weiwei Xu, Qinxue Li, Tianyu Li, Yue Tian, Bochuan Huang, Diederick E. Grobbee, Manuel Castro Cabezas, Jinqing Yuan · 发表于：European Journal of Preventive Cardiology · 年份：2025 · DOI：10.1093/eurjpc/zwaf330 · 被引用次数：4 · 研究领域：Alcohol Consumption and Health Effects、Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation

BACKGROUND & AIMS: Steatotic liver disease (SLD) is an overarching term to encompass metabolic-dysfunction associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD). However, the impact of metabolic syndrome (MetS) on the association between SLD and mortality risk remains uncertain. This study aims to compare all-cause and cause-specific mortality across SLD subtypes stratified by MetS. METHODS: A population-based cohort study was conducted using NHANES Ⅲ data, including 9,217 participants stratified by MetS status and further categorized into no SLD, MASLD, MetALD, and ALD groups. MetS was defined according to the International Diabetes Federation criteria. RESULTS: Over a median follow-up of 26.4 years, 3,521 mortality events occurred. After adjustment, SLD with MetS was significantly associated with an increased risk of all-cause mortality compared with healthy controls (HR 1.56, 95% CI 1.38-1.75). This association persisted across all SLD subtypes (MASLD: HR 1.52, 95% CI 1.34-1.72; MetALD: HR 1.92, 95% CI 1.41-2.62; ALD: HR 2.80, 95% CI 1.56-5.05). In contrast, no significant association was found between SLD subtypes without MetS and mortality risk. When stratified by MetS presence, MASLD, MetALD and ALD were each significantly associated with increased mortality risks compared to the no SLD group in individuals with MetS, primarily driven by high cancer-related and diabetes-related mortality. How...