Hyoeun Kim1, Chan Joo Lee2, Byoung Kwon Lee3, Seung Up Kim4,5, Jung Il Lee6,7, Sang Hoon Ahn6,8, Kwan Sik Lee6,7, Su Jung Baik9. 1. Department of Health Promotion, Severance Health Check-Up, Severance Hospital, Yonsei University Health System, Seoul, Korea. 2. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. 3. Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 4. Department of Internal Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea. ksukorea@yuhs.ac. 5. Yonsei Liver Center, Severance Hospital, Seoul, Korea. ksukorea@yuhs.ac. 6. Department of Internal Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea. 7. Division of Gastroenterology and Hepatology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 8. Yonsei Liver Center, Severance Hospital, Seoul, Korea. 9. Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, Seoul, Korea.
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.
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.
Authors: Carolin V Schneider; Karim Hamesch; Annika Gross; Mattias Mandorfer; Linda S Moeller; Vitor Pereira; Monica Pons; Pawel Kuca; Matthias C Reichert; Federica Benini; Barbara Burbaum; Jessica Voss; Marla Gutberlet; Vivien Woditsch; Cecilia Lindhauer; Malin Fromme; Julia Kümpers; Lisa Bewersdorf; Benedikt Schaefer; Mohammed Eslam; Robert Bals; Sabina Janciauskiene; Joana Carvão; Daniel Neureiter; Biaohuan Zhou; Katharina Wöran; Heike Bantel; Andreas Geier; Timm Dirrichs; Felix Stickel; Alexander Teumer; Jef Verbeek; Frederik Nevens; Olivier Govaere; Marcin Krawczyk; Tania Roskams; Johannes Haybaeck; Georg Lurje; Joanna Chorostowska-Wynimko; Joan Genesca; Thomas Reiberger; Frank Lammert; Aleksander Krag; Jacob George; Quentin M Anstee; Michael Trauner; Christian Datz; Nadine T Gaisa; Helmut Denk; Christian Trautwein; Elmar Aigner; Pavel Strnad Journal: Gastroenterology Date: 2020-05-04 Impact factor: 22.682