Abstract
Background/purpose: Metabolic dysfunction (MD)-associated fatty liver disease (MAFLD) is new clearer nomenclature with positive diagnostic criteria on the basis of hepatic steatosis and MD, involving exclusion criteria for nonalcoholic fatty liver disease (NAFLD).Methods: This retrospective cohort study included 333,389 participants who received health examination between 2009 and 2010 from the Korean National Health Insurance Service database. Hepatic steatosis was defined using the Korean National Health and Nutrition Examination Survey-derived NAFLD scoring system. Participants were followed over 5-6 years from the index date of health examination to 31 December 2015 for cardiovascular disease (CVD). The Cox proportional hazards regression was adopted to determine adjusted hazard ratio (aHR) with 95% confidence interval (CI) for CVD according to the presence of hepatic steatosis, MD, and MAFLD.Results: This study included 179,437 men and 153,952 women with a median age of 57 years. Hepatic steatosis with MD (aHR, 2.00; 95% CI, 1.89-2.13) and without MD (aHR, 1.30; 95% CI, 1.10-1.54) significantly increased the risk of CVD compared to no steatosis without MD (reference). However, steatosis revealed no significant difference in the risk of CVD compared to no steatosis among participants with one metabolic dysfunction (aHR, 1.09; 95% CI, 0.91-1.30). In participants with steatosis, the presence of one and ≥2 metabolic dysfunctions had aHR of 1.25 (95% CI, 0.87-1.79) and 1.71 (95% CI, 1.22-2.41) compared to no MD, respectively.Conclusion: MAFLD was significantly associated with increased CVD risk and had better predictive performance for CVD risk compared to hepatic steatosis or metabolic dysfunction alone.
Non-alcoholic fatty liver disease is associated with cardiovascular disease risk markers
