Prognostic and Predictive Effects of New Steatotic Liver Disease Nomenclatures: a Large Population-based Study

Overview

Journal MedComm (2020)

Specialty Health Services

Date 2025 Feb 14

PMID 39949980

Authors

Huixian Zeng

Letian Fang

Zhiyu Yang

Xinyu Zhao

Hongsen Chen

Puyi Xing

Zheyun Niu

Zheng Li

Zishuai Li

Jiayi Zhao

Wenbin Liu

Chunxia Jing

Hong You

Guangwen Cao

Affiliations

Soon will be listed here.

Abstract

We aimed to compare the association of metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-related liver disease (ALD), metabolic dysfunction and ALD (MetALD), and MASLD with viral hepatitis (MASLD-Viral) with risks of cirrhosis, liver cancer, and mortality. The data of 464,556 adults from the UK Biobank (UKB), 13,526 adults from the National Health and Nutrition Examination Survey (NHANES), and 2554 adults from BeijngFH Health Cohort Study (FHCS) were included. Adjusted hazard ratios (aHR) and odds ratios were calculated using Cox and Logistic regression models, respectively. Compared with non-SLD, the risk of liver cancer increased from MetALD (aHR 1.70 [95% CI 1.37, 2.09]), MASLD (1.91 [1.66, 2.21]), MAFLD (2.01 [1.76, 2.29]), ALD (3.16 [2.54, 3.93]), to MASLD-Viral (22.0 [10.8, 44.4]) in a stepwise manner in the UKB; the risk of all-cause mortality increased from MetALD, MASLD, MAFLD, ALD, to MASLD-Viral in the NHANES. The odds ratio of liver fibrosis increased from MASLD, MAFLD, to MASLD-Viral in the FHCS. In patients with diabetes, metformin plus other drugs were associated with higher risks of cirrhosis, liver cancer, and all-cause mortality in MASLD or MAFLD. Prevention rather than antiglycemic treatment is important for patients with diabetic MASLD or MAFLD.

References

Younossi Z, Paik J, Al Shabeeb R, Golabi P, Younossi I, Henry L . Are there outcome differences between NAFLD and metabolic-associated fatty liver disease?. Hepatology. 2022; 76(5):1423-1437. DOI: 10.1002/hep.32499. View

Musso G, Cassader M, Rosina F, Gambino R . Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabetologia. 2012; 55(4):885-904. DOI: 10.1007/s00125-011-2446-4. View

Kim G, Moon J, Kim W . Critical appraisal of metabolic dysfunction-associated steatotic liver disease: Implication of Janus-faced modernity. Clin Mol Hepatol. 2023; 29(4):831-843. PMC: 10577343. DOI: 10.3350/cmh.2023.0277. View

Wu J, Zhu A . Targeting insulin-like growth factor axis in hepatocellular carcinoma. J Hematol Oncol. 2011; 4:30. PMC: 3141798. DOI: 10.1186/1756-8722-4-30. View

Kim M, Han K, Yoo J, Hwang S, Zhang X, Ahn S . Diabetic MAFLD is associated with increased risk of hepatocellular carcinoma and mortality in chronic viral hepatitis patients. Int J Cancer. 2023; 153(8):1448-1458. DOI: 10.1002/ijc.34637. View

Sumida Y, Yoneda M, Hyogo H, Itoh Y, Ono M, Fujii H . Validation of the FIB4 index in a Japanese nonalcoholic fatty liver disease population. BMC Gastroenterol. 2012; 12:2. PMC: 3266187. DOI: 10.1186/1471-230X-12-2. View

Ajmera V, Cepin S, Tesfai K, Hofflich H, Cadman K, Lopez S . A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes. J Hepatol. 2022; 78(3):471-478. PMC: 9975077. DOI: 10.1016/j.jhep.2022.11.010. View

. EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Obes Facts. 2024; 17(4):374-444. PMC: 11299976. DOI: 10.1159/000539371. View

Israelsen M, Torp N, Johansen S, Hansen C, Hansen E, Thorhauge K . Validation of the new nomenclature of steatotic liver disease in patients with a history of excessive alcohol intake: an analysis of data from a prospective cohort study. Lancet Gastroenterol Hepatol. 2024; 9(3):218-228. DOI: 10.1016/S2468-1253(23)00443-0. View

10.

Collins R . What makes UK Biobank special?. Lancet. 2012; 379(9822):1173-4. DOI: 10.1016/S0140-6736(12)60404-8. View

11.

Rinella M, Lazarus J, Ratziu V, Francque S, Sanyal A, Kanwal F . A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023; 79(6):1542-1556. DOI: 10.1016/j.jhep.2023.06.003. View

12.

Villamil F, Barbero M, Massenzio N, Giani S, Kozima S, Cairo F . Prevalence of non-alcoholic fatty liver disease and liver fibrosis in a general population cohort from Argentina. Ann Hepatol. 2023; 28(4):101111. DOI: 10.1016/j.aohep.2023.101111. View

13.

Nar A, Gedik O . The effect of metformin on leptin in obese patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease. Acta Diabetol. 2008; 46(2):113-8. DOI: 10.1007/s00592-008-0067-2. View

14.

Perazzo H, Pacheco A, Griep R . Changing from NAFLD through MAFLD to MASLD: Similar prevalence and risk factors in a large Brazilian cohort. J Hepatol. 2023; 80(2):e72-e74. DOI: 10.1016/j.jhep.2023.08.025. View

15.

Hagstrom H, Vessby J, Ekstedt M, Shang Y . 99% of patients with NAFLD meet MASLD criteria and natural history is therefore identical. J Hepatol. 2023; 80(2):e76-e77. DOI: 10.1016/j.jhep.2023.08.026. View

16.

Choi H, Brouwer W, Zanjir W, de Man R, Feld J, Hansen B . Nonalcoholic Steatohepatitis Is Associated With Liver-Related Outcomes and All-Cause Mortality in Chronic Hepatitis B. Hepatology. 2019; 71(2):539-548. DOI: 10.1002/hep.30857. View

17.

Haukeland J, Konopski Z, Eggesbo H, von Volkmann H, Raschpichler G, Bjoro K . Metformin in patients with non-alcoholic fatty liver disease: a randomized, controlled trial. Scand J Gastroenterol. 2009; 44(7):853-60. DOI: 10.1080/00365520902845268. View

18.

Mao X, Cheung K, Peng C, Mak L, Cheng H, Fung J . Steatosis, HBV-related HCC, cirrhosis, and HBsAg seroclearance: A systematic review and meta-analysis. Hepatology. 2022; 77(5):1735-1745. DOI: 10.1002/hep.32792. View

19.

Eslam M, Sanyal A, George J . MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020; 158(7):1999-2014.e1. DOI: 10.1053/j.gastro.2019.11.312. View

20.

. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016; 64(6):1388-402. DOI: 10.1016/j.jhep.2015.11.004. View