TY - JOUR
T1 - Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease
T2 - A Meta-analysis of 129 Studies
AU - Chan, Kai En
AU - Ong, Elden Yen Hng
AU - Chung, Charlotte Hui
AU - Ong, Christen En Ya
AU - Koh, Benjamin
AU - Tan, Darren Jun Hao
AU - Lim, Wen Hui
AU - Yong, Jie Ning
AU - Xiao, Jieling
AU - Wong, Zhen Yu
AU - Syn, Nicholas
AU - Kaewdech, Apichat
AU - Teng, Margaret
AU - Wang, Jiong Wei
AU - Chew, Nicholas
AU - Young, Dan Yock
AU - Know, Alfred
AU - Siddiqui, Mohammad Shadab
AU - Huang, Daniel Q.
AU - Tamaki, Nobuharu
AU - Wong, Vincent Wai Sun
AU - Mantzoros, Christos S.
AU - Sanyal, Arun
AU - Noureddin, Mazen
AU - Ng, Cheng Han
AU - Muthiah, Mark
N1 - Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.
PY - 2023/9/28
Y1 - 2023/9/28
N2 - Background & Aims: The progression of metabolic dysfunction-associated steatotic liver disease (MASLD) has been found to manifest in a series of hepatic and extrahepatic complications. A comprehensive meta-analysis of the longitudinal outcomes associated with MASLD has yet to be conducted. Methods: To investigate the longitudinal outcomes associated with MASLD, Medline and Embase databases were searched to identify original studies that evaluated the longitudinal risks of incident clinical outcomes among MASLD patients compared with non-MASLD individuals. DerSimonian Laird random-effects meta-analysis was performed. Pooled effect estimates were calculated, and heterogeneity among studies was evaluated. Results: One hundred twenty-nine studies were included in the meta-analysis. Meta-analysis revealed a significant increase in the risk of cardiovascular outcomes (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.27–1.60; P < .01), various metabolic outcomes such as incident hypertension (HR, 1.75; 95% CI, 1.46–2.08; P < .01), diabetes (HR, 2.56; 95% CI, 2.10–3.13; P < .01), pre-diabetes (HR, 1.69; 95% CI, 1.22–2.35; P < .01), metabolic syndrome (HR, 2.57; 95% CI, 1.13–5.85; P = .02), chronic kidney disease (HR, 1.38; 95% CI, 1.27–1.50; P < .01), as well as all cancers (HR, 1.54; 95% CI, 1.35–1.76; P < .01) among MASLD patients compared with non-MASLD individuals. By subgroup analysis, MASLD patients with advanced liver disease (HR, 3.60; 95% CI, 2.10–6.18; P < .01) were also found to be associated with a significantly greater risk (P = .02) of incident diabetes than those with less severe MASLD (HR, 1.63; 95% CI, 1.0–2.45; P = .02) when compared with non-MASLD. Conclusions: The present study emphasizes the association between MASLD and its clinical outcomes including cardiovascular, metabolic, oncologic, and other outcomes. The multisystemic nature of MASLD found in this analysis requires treatment targets to reduce systemic events and end organ complications.
AB - Background & Aims: The progression of metabolic dysfunction-associated steatotic liver disease (MASLD) has been found to manifest in a series of hepatic and extrahepatic complications. A comprehensive meta-analysis of the longitudinal outcomes associated with MASLD has yet to be conducted. Methods: To investigate the longitudinal outcomes associated with MASLD, Medline and Embase databases were searched to identify original studies that evaluated the longitudinal risks of incident clinical outcomes among MASLD patients compared with non-MASLD individuals. DerSimonian Laird random-effects meta-analysis was performed. Pooled effect estimates were calculated, and heterogeneity among studies was evaluated. Results: One hundred twenty-nine studies were included in the meta-analysis. Meta-analysis revealed a significant increase in the risk of cardiovascular outcomes (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.27–1.60; P < .01), various metabolic outcomes such as incident hypertension (HR, 1.75; 95% CI, 1.46–2.08; P < .01), diabetes (HR, 2.56; 95% CI, 2.10–3.13; P < .01), pre-diabetes (HR, 1.69; 95% CI, 1.22–2.35; P < .01), metabolic syndrome (HR, 2.57; 95% CI, 1.13–5.85; P = .02), chronic kidney disease (HR, 1.38; 95% CI, 1.27–1.50; P < .01), as well as all cancers (HR, 1.54; 95% CI, 1.35–1.76; P < .01) among MASLD patients compared with non-MASLD individuals. By subgroup analysis, MASLD patients with advanced liver disease (HR, 3.60; 95% CI, 2.10–6.18; P < .01) were also found to be associated with a significantly greater risk (P = .02) of incident diabetes than those with less severe MASLD (HR, 1.63; 95% CI, 1.0–2.45; P = .02) when compared with non-MASLD. Conclusions: The present study emphasizes the association between MASLD and its clinical outcomes including cardiovascular, metabolic, oncologic, and other outcomes. The multisystemic nature of MASLD found in this analysis requires treatment targets to reduce systemic events and end organ complications.
KW - Clinical Outcomes
KW - Longitudinal Risks
KW - Metabolic Diseases
KW - Metabolic Dysfunction-Associated Steatotic Liver Disease
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UR - http://www.scopus.com/inward/citedby.url?scp=85178209646&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2023.09.018
DO - 10.1016/j.cgh.2023.09.018
M3 - Review article
C2 - 37775028
SN - 1542-3565
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
ER -