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May 31, 2022PLoS ONEOpen Access

DM-MAFLD had significantly higher odds for coronary artery calcification score > 100 (OR 5.833, 95% CI 3.047-11.164) compared to subjects with neither fatty liver disease.

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Why the study?

The association between subclinical atherosclerosis and MAFLD or NAFLD, and the synergistic effect of DM and MAFLD on subclinical atherosclerosis, remained to be investigated.

Does metabolic dysfunction-associated fatty liver disease (MAFLD) and its combination with diabetes mellitus associate with increased subclinical atherosclerosis in a general health checkup population?

Population

890 subjects undergoing health checkups with CAC, carotid intima-media thickness, and ba-PWV

Comparison

MAFLD vs NAFLD vs Neither-FLD, and MAFLD subgroups (Obesity-MAFLD, Lean-MAFLD, DM-MAFLD)

Design

Cross-sectional study

Authors

RBRieko BesshoKKKazuhiro KashiwagiAIAkihiko Ikura

Discussion

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Overview

DM-MAFLD was associated with higher CAC>100 odds; hypothesis-generating for atherosclerosis risk stratification pending prospective validation.

Structured PICO

Does metabolic dysfunction-associated fatty liver disease (MAFLD) and its combination with diabetes mellitus associate with increased subclinical atherosclerosis in a general health checkup population?

P
Population
890 subjects who underwent health checkups with coronary artery calcification (CAC), carotid intima-media thickness, and brachial-ankle pulse wave velocity (ba-PWV) evaluations at a preventive medicine center in Japan. Mean age 60.2 years, 67.2% male. Excluded: heart diseases such as chronic heart failure or arrhythmia.
I
Intervention
Presence of metabolic dysfunction-associated fatty liver disease (MAFLD), including subgroups Obesity-MAFLD, Lean-MAFLD, and DM-MAFLD, or non-alcoholic fatty liver disease (NAFLD).
C
Comparator
Subjects without MAFLD or NAFLD (Neither-FLD).
O
Outcome
Subclinical atherosclerosis assessed by coronary artery calcification score (CACS > 0 or > 100), brachial-ankle pulse wave velocity (ba-PWV > 1400 cm/s), and carotid intima-media thickness (c-IMT ≥ 1.1 mm).surrogate

MAFLD, particularly when combined with diabetes mellitus, is significantly associated with a higher risk of subclinical atherosclerosis compared to NAFLD or the absence of fatty liver disease.

Limitations

  • Cross-sectional study cannot conclude a causal link between subclinical atherosclerosis and MAFLD
  • Diagnosis of FLD was determined by ultrasound, not by more sensitive and specific modalities such as MRI or US elastography
  • Small number of subjects in the MAFLD-DM+ group
  • Derived from Japanese health checkup data, findings may not be generalized to other races

Cite This Study

Bessho et al. (2022) studied this question.

synapsesocial.com/papers/6a1fd5afeea2c6885e117faehttps://doi.org/10.1371/journal.pone.0269265
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