Wang Daniel R, Famini Pouyan, Shamsa Kamran
Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
J Clin Gastroenterol. 2025 Aug 1;59(7):621-625. doi: 10.1097/MCG.0000000000002176.
Metabolic dysfunction-associated steatotic liver disease (MASLD), represents a growing global health concern, affecting over 25% of adults worldwide. The disease spectrum ranges from asymptomatic steatosis to advanced metabolic dysfunction-associated steatohepatitis (MASH), which predisposes individuals to severe complications, such as cirrhosis and hepatocellular carcinoma. MASLD shares a complex pathophysiological overlap with cardiovascular disease (CVD), with both conditions influenced by common risk factors, such as insulin resistance, obesity, dyslipidemia, and hypertension. These shared mechanisms, including impaired glucose metabolism, endothelial dysfunction, and vascular inflammation, significantly increase the risk of cardiovascular events in MASLD patients. Moreover, racial and ethnic disparities further complicate the management of MASLD and CVD, highlighting the need for tailored screening and intervention strategies. This review explores the intertwined relationship between MASLD and CVD, focusing on their shared risk factors, mechanisms, and the importance of integrated, multidisciplinary care to mitigate the elevated cardiovascular risks in this high-risk patient population. Early diagnosis, effective risk stratification, and comprehensive management are crucial for reducing long-term morbidity and mortality in patients with MASLD.
代谢功能障碍相关脂肪性肝病(MASLD)是一个日益引起全球健康关注的问题,影响着全球超过25%的成年人。该疾病谱涵盖从无症状脂肪变性到晚期代谢功能障碍相关脂肪性肝炎(MASH),后者使个体易患严重并发症,如肝硬化和肝细胞癌。MASLD与心血管疾病(CVD)存在复杂的病理生理重叠,这两种疾病都受胰岛素抵抗、肥胖、血脂异常和高血压等共同危险因素的影响。这些共同机制,包括糖代谢受损、内皮功能障碍和血管炎症,显著增加了MASLD患者发生心血管事件的风险。此外,种族和民族差异使MASLD和CVD的管理更加复杂,凸显了制定针对性筛查和干预策略的必要性。本综述探讨了MASLD与CVD之间的相互关系,重点关注它们的共同危险因素、机制以及综合多学科护理对于降低这一高危患者群体心血管风险升高的重要性。早期诊断、有效的风险分层和全面管理对于降低MASLD患者的长期发病率和死亡率至关重要。