Metabolic dysfunction-associated steatotic liver disease and diabetes: Together against the heart

Cardiovascular events are the main cause of mortality in individuals with type 2 diabetes mellitus (T2DM) and also in those with metabolic dysfunction-associated steatotic liver disease (MASLD). In this editorial, we comment on the results of a meta-analysis published by Shetty et al that shows an addictive risk for cardiovascular events when both pathologies are together. Patients with MASLD and T2DM have the worst prognosis related to liver disease since they have a higher risk for metabolic dysfunction-associated steatohepatitis, disease progression, and hepatocarcinoma. The meta-analysis included 370013 participants and showed that, although with high heterogeneity, there is a higher prevalence of cardiovascular events in patients with T2DM when MASLD is diagnosed compared to those without MASLD. Hence, MASLD and T2DM may have a new interplay regarding cardiovascular outcomes in addition to the already known liver-related outcomes.