What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) (n=2773). Intervention: Metabolic dysfunction-associated steatotic liver disease (MASLD) vs. No MASLD. Primary outcome: Presence of coronary artery calcification (CAC score > 0) (aOR 1.21, 95% CI 1.02-1.44, p=0.033).

October 2, 2024Scientific Reports12 citationsOpen Access

Comparative associations of MASLD and MAFLD with the presence and severity of coronary artery calcification

MKMin Kyu Kang JSJeong Eun Song RLRohit Loomba

Key Result

Both MASLD (aOR 1.21) and MAFLD (aOR 1.20) were associated with the presence of coronary artery calcification, whereas only MASLD (aOR 1.38) was significantly associated with severe calcification.

Study Design

Type

Cross-Sectional (n=2,773)

Multicenter

Yes

Structured PICO

Are MASLD and MAFLD associated with the presence and severity of coronary artery calcification?

Population

2,773 asymptomatic adults who underwent comprehensive health screening with abdominal ultrasonography and cardiac CT in South Korea.

Exposure

Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD)

Comparator

No MASLD or MAFLD (reference group)

Outcome

Presence of CAC (CAC score > 0) and severity of CAC (CAC score > 300)surrogate

MASLD may be a more effective predictor of severe coronary artery calcification and higher ASCVD risk compared to MAFLD.

Main Result

Odds Ratio: 1.21 (95% CI 1.02–1.44)

Absolute Event Rate: 43.8% vs 35.5%

p-value: p=0.033

Limitations

Cross-sectional retrospective study design cannot establish causality with CVD.
Selection bias due to inclusion of individuals who voluntarily visited health-promotion centers and could afford full tests.
Non-contrast cardiac CT cannot quantify non-calcified plaque burden.
Did not measure epicardial adipose distribution.
Conducted only in South Korea, potentially restricting generalizability.
Hepatic steatosis was diagnosed using abdominal ultrasound, which is subject to variability and inaccurate detection of mild steatosis.
Lack of HOMA-IR measurements for MAFLD criteria.

Abstract

We aimed to compare the associations of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) with coronary artery calcification (CAC). Patients who simultaneously underwent ultrasonography to diagnose hepatic steatosis and cardiac computed tomography to detect CAC were included. The presence and severity of CAC were defined with CAC-score thresholds of > 0 and > 300, respectively, and patients were divided into the following groups: no MASLD or MAFLD (reference), MASLD-only, MAFLD-only, and overlapping groups. Overall, 1,060/2,773 (38.2%) patients had CAC, of which 196 (18.5%) had severe CAC. The MASLD and MAFLD prevalence rates were 32.6% and 45.2%, respectively, with an overlap of 30.7%. In an ASCVD risk score-adjusted model, both MASLD (adjusted odd ratios aOR, 1.21; 95% confidence interval CI, 1.02-1.44; p = 0.033) and MAFLD (aOR 1.20; 95% CI 1.01-1.42, p = 0.034) were associated with CAC, whereas only MASLD (aOR 1.38; 95% CI 1.01-1.89, p = 0.041) was associated with severe CAC. Compared to the reference group, the overlapping group showed an association with CAC (aOR 1.22; 95% CI 1.01-1.47; p = 0.038); however, the MASLD and MAFLD subgroups did not differ in their association with CAC. MASLD may predict a higher risk of ASCVD more effectively than MAFLD.

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Cite This Study

Kang et al. (Wed,) conducted a cross-sectional in Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) (n=2,773). Metabolic dysfunction-associated steatotic liver disease (MASLD) vs. No MASLD was evaluated on Presence of coronary artery calcification (CAC score > 0) (aOR 1.21, 95% CI 1.02-1.44, p=0.033). Both MASLD (aOR 1.21) and MAFLD (aOR 1.20) were associated with the presence of coronary artery calcification, whereas only MASLD (aOR 1.38) was significantly associated with severe calcification.

synapsesocial.com/papers/6a618c296b7099fe363f64a6 https://doi.org/https://doi.org/10.1038/s41598-024-74287-7

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