Correlation Between Metabolic Dysfunction-associated Steatotic Liver Disease and Subclinical Coronary Atherosclerosis in Eastern China

Overview

Journal Diabetol Metab Syndr

Publisher Biomed Central

Date 2025 Jan 15

PMID 39815332

Authors

Guanghui Ma

Guohou Xu

Haixia Huang

Affiliations

Soon will be listed here.

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the presence of at least one cardiovascular disease (CVD) risk factor, underscoring its potential to elevate CVD risk in affected individuals. However, evidence linking MASLD to subclinical coronary atherosclerosis remains scarce, and further investigations are necessary to elucidate the independent role of varying MASLD severities as a CVD risk factor.

Methods: This study analyzed 7,507 participants aged ≥ 40 who underwent comprehensive health evaluations at the Shanghai Health and Medical Center. Logistic regression analysis was utilized to explore the relationship between MASLD severity and the presence of coronary artery calcification (CAC). Correlation analysis was performed to assess the association between MASLD severity and CAC staging.

Results: After adjusting for established CVD risk factors, MASLD showed a significant association with CAC, which intensified with increasing MASLD severity. Among individuals with hypertension, MASLD was markedly correlated with CAC. In contrast, in non-hypertensive participants, only moderate and severe MASLD were significantly associated with CAC, while mild MASLD demonstrated no notable link, even after adjustment for CVD risk factors. Moreover, correlation analysis revealed a positive association between MASLD severity and CAC staging, indicating that higher MASLD severity aligned with more advanced CAC stages.

Conclusion: This study highlighted that MASLD severity was independently associated with subclinical atherosclerosis, irrespective of traditional CVD risk factors, in an urban eastern Chinese population without a prior history of coronary atherosclerosis. The strongest associations were observed in individuals with severe MASLD, emphasizing the importance of assessing MASLD severity in CVD risk stratification.

References

Duell P, Welty F, Miller M, Chait A, Hammond G, Ahmad Z . Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol. 2022; 42(6):e168-e185. DOI: 10.1161/ATV.0000000000000153. View

Kang M, Song J, Loomba R, Park S, Tak W, Kweon Y . Comparative associations of MASLD and MAFLD with the presence and severity of coronary artery calcification. Sci Rep. 2024; 14(1):22917. PMC: 11447001. DOI: 10.1038/s41598-024-74287-7. View

Sakaguchi M, Fukuda S, Shimada K, Izumi Y, Izumiya Y, Nakamura Y . Preliminary observations of passive exercise using whole body periodic acceleration on coronary microcirculation and glucose tolerance in patients with type 2 diabetes. J Cardiol. 2012; 60(4):283-7. DOI: 10.1016/j.jjcc.2012.05.006. View

Loomba R, Wong V . Implications of the new nomenclature of steatotic liver disease and definition of metabolic dysfunction-associated steatotic liver disease. Aliment Pharmacol Ther. 2023; 59(2):150-156. PMC: 10807722. DOI: 10.1111/apt.17846. View

Le M, Le D, Baez T, Dang H, Nguyen V, Lee K . Global incidence of adverse clinical events in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Clin Mol Hepatol. 2024; 30(2):235-246. PMC: 11016479. DOI: 10.3350/cmh.2023.0485. View

Budoff M, McClelland R, Nasir K, Greenland P, Kronmal R, Kondos G . Cardiovascular events with absent or minimal coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2009; 158(4):554-61. PMC: 2766514. DOI: 10.1016/j.ahj.2009.08.007. View

Toh J, Pan X, Tay P, Ng C, Yong J, Xiao J . A Meta-Analysis on the Global Prevalence, Risk factors and Screening of Coronary Heart Disease in Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol. 2021; 20(11):2462-2473.e10. DOI: 10.1016/j.cgh.2021.09.021. View

Li G, Lu Z, Chen Z . Identification of common signature genes and pathways underlying the pathogenesis association between nonalcoholic fatty liver disease and heart failure. Front Immunol. 2024; 15:1424308. PMC: 11439677. DOI: 10.3389/fimmu.2024.1424308. View

Chan K, Koh T, Tang A, Quek J, Yong J, Tay P . Global Prevalence and Clinical Characteristics of Metabolic-associated Fatty Liver Disease: A Meta-Analysis and Systematic Review of 10 739 607 Individuals. J Clin Endocrinol Metab. 2022; 107(9):2691-2700. DOI: 10.1210/clinem/dgac321. View

10.

. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024; 81(3):492-542. DOI: 10.1016/j.jhep.2024.04.031. View

11.

Grundy S, Stone N, Bailey A, Beam C, Birtcher K, Blumenthal R . 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018; 139(25):e1082-e1143. PMC: 7403606. DOI: 10.1161/CIR.0000000000000625. View

12.

Ferraioli G, Soares Monteiro L . Ultrasound-based techniques for the diagnosis of liver steatosis. World J Gastroenterol. 2019; 25(40):6053-6062. PMC: 6824276. DOI: 10.3748/wjg.v25.i40.6053. View

13.

Hecht H, Blaha M, Berman D, Nasir K, Budoff M, Leipsic J . Clinical indications for coronary artery calcium scoring in asymptomatic patients: Expert consensus statement from the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr. 2017; 11(2):157-168. DOI: 10.1016/j.jcct.2017.02.010. View

14.

Choe H, Moon J, Kim W, Koo B, Cho N . Steatotic liver disease predicts cardiovascular disease and advanced liver fibrosis: A community-dwelling cohort study with 20-year follow-up. Metabolism. 2024; 153:155800. DOI: 10.1016/j.metabol.2024.155800. View

15.

Moon J, Jeong S, Jang H, Koo B, Kim W . Metabolic dysfunction-associated steatotic liver disease increases the risk of incident cardiovascular disease: a nationwide cohort study. EClinicalMedicine. 2023; 65:102292. PMC: 10632413. DOI: 10.1016/j.eclinm.2023.102292. View

16.

Hecht H, Cronin P, Blaha M, Budoff M, Kazerooni E, Narula J . 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology. J Cardiovasc Comput Tomogr. 2016; 11(1):74-84. DOI: 10.1016/j.jcct.2016.11.003. View

17.

Younossi Z, Koenig A, Abdelatif D, Fazel Y, Henry L, Wymer M . Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2015; 64(1):73-84. DOI: 10.1002/hep.28431. View

18.

Lee H, Lee H, Kim E, Kim H, Kim H, Ahn S . Metabolic dysfunction-associated steatotic liver disease and risk of cardiovascular disease. Gut. 2023; 73(3):533-540. DOI: 10.1136/gutjnl-2023-331003. View

19.

Targher G, Byrne C, Lonardo A, Zoppini G, Barbui C . Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. 2016; 65(3):589-600. DOI: 10.1016/j.jhep.2016.05.013. View

20.

Stahl E, Dhindsa D, Lee S, Sandesara P, Chalasani N, Sperling L . Nonalcoholic Fatty Liver Disease and the Heart: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019; 73(8):948-963. DOI: 10.1016/j.jacc.2018.11.050. View