Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Nutr Metab Cardiovasc Dis. 2024 Sep;34(9):2085-2094. doi: 10.1016/j.numecd.2024.05.018. Epub 2024 May 22.
Recently, metabolic dysfunction-associated steatotic liver disease (MASLD) has been introduced. However, research on this new nomenclature and definition remains limited. This study aims to assess the impact of cardiometabolic risk factors and alcohol consumption on all-cause mortality in MASLD and its subgroups.
We included 2408 participants with MASLD in NHANES III and their linked mortality through 2019. MASLD patients were divided into two groups based on alcohol consumption: Pure MASLD and MetALD. The Cox proportional hazard model was used to assess the association between factors and all-cause mortality. During the median 26.0-year follow-up, there were 1040 deaths. The multivariable Cox regression analysis revealed a significant increase of over two-fold in the all-cause mortality rate among patients with four or more cardiometabolic risk factors compared to those with only one. When focusing on each component of cardiometabolic risk factors individually, only diabetes and hypertension were significantly associated with all-cause mortality (p < 0.05). In a subgroup analysis, each additional cardiometabolic factor was linked to an increase in all-cause mortality in both pure MASLD (hazard ratio 1.16; 95% CI 1.06-1.28; p = 0.002) and MetALD (HR 1.77; 95% CI 1.26-2.49; p = 0.001). Notably, an elevation in alcohol consumption was significantly associated with an increase in all-cause mortality rate only in the MetALD (p < 0.001).
This study found that the presence of diabetes or hypertension was significantly associated with all-cause mortality. We also explored the different impacts of these factors and alcohol consumption within MASLD subgroups.
最近，代谢功能障碍相关脂肪性肝病（MASLD）被提出。然而，关于这一新命名和定义的研究仍然有限。本研究旨在评估心血管代谢危险因素和酒精摄入对 MASLD 及其亚组全因死亡率的影响。
我们纳入了 NHANES III 中 2408 名 MASLD 患者及其通过 2019 年的相关死亡率。根据酒精摄入情况，MASLD 患者分为两组：纯 MASLD 和 MetALD。使用 Cox 比例风险模型评估因素与全因死亡率之间的关系。在中位数为 26.0 年的随访期间，有 1040 人死亡。多变量 Cox 回归分析显示，与仅有一种心血管代谢危险因素的患者相比，有四种或更多心血管代谢危险因素的患者全因死亡率增加了两倍多。当单独关注心血管代谢危险因素的每个组成部分时，只有糖尿病和高血压与全因死亡率显著相关（p<0.05）。在亚组分析中，在纯 MASLD（风险比 1.16；95%CI 1.06-1.28；p=0.002）和 MetALD（HR 1.77；95%CI 1.26-2.49；p=0.001）中，每增加一个心血管代谢因素与全因死亡率的增加相关。值得注意的是，酒精摄入的升高仅在 MetALD 中与全因死亡率的升高显著相关（p<0.001）。
本研究发现糖尿病或高血压的存在与全因死亡率显著相关。我们还探讨了这些因素和酒精摄入在 MASLD 亚组中的不同影响。
