Gries Jacob J, Lazarus Jeffrey V, Brennan Paul N, Siddiqui Mohammad S, Targher Giovanni, Lang Chim C, Virani Salim S, Lavie Carl J, Isaacs Scott, Arab Juan Pablo, Cusi Kenneth, Krittanawong Chayakrit
Department of Internal Medicine, Geisinger Medical Center, Danville, PA, USA.
CUNY Graduate School of Public Health and Health Policy, New York, NY, USA; Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, Barcelona, Spain.
Lancet Gastroenterol Hepatol. 2025 Jan;10(1):82-94. doi: 10.1016/S2468-1253(24)00310-8.
Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide. This Review takes an interdisciplinary approach, drawing on hepatology, cardiology, endocrinology, and metabolic and internal medicine specialists to help to delineate the intricate interplay between MASLD and coronary artery disease. It sheds light on novel opportunities for targeted interventions and personalised management strategies.
代谢功能障碍相关脂肪性肝病（MASLD）已成为一种公共卫生威胁，因为它影响着全球约38%的成年人口，其患病率随着肥胖和2型糖尿病的患病率上升而上升。除了MASLD对肝脏健康的影响外，它还与心血管和血管功能障碍有关。尽管许多共同的风险因素和共同的代谢环境可能表明心血管疾病和MASLD是常见全身发病机制的不同结果，但越来越多的证据表明MASLD与冠状动脉疾病之间存在潜在的因果关系，冠状动脉疾病是MASLD患者发病和死亡的主要原因，也是全球全因死亡率的主要原因。本综述采用跨学科方法，借鉴肝病学、心脏病学、内分泌学以及代谢和内科专家的意见，以帮助阐明MASLD与冠状动脉疾病之间复杂的相互作用。它揭示了靶向干预和个性化管理策略的新机会。
