Natural history of lean and non-lean metabolic dysfunction-associated steatotic liver disease

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2024-04-04 DOI:10.1007/s00535-024-02093-z

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引用次数: 0

Abstract

Background

Conflicting evidence regarding the prognosis of lean metabolic dysfunction-associated steatotic liver disease (MASLD) has raised substantial questions.

Aim

This study aimed to elucidate the prognosis of lean MASLD by conducting a comprehensive analysis of a vast Asian cohort.

Methods

This study used a nationwide, population-based database and analyzed 2.9 million patients. The primary endpoints were liver-related events (LREs) and cardiovascular events (CVEs) in patients with lean MASLD, non-lean MASLD, and normal liver control groups.

Results

The median observation period was 4.2 years. The 5-year incidence values of LREs in the lean MASLD, non-lean MASLD, and normal liver control groups were 0.065%, 0.039%, and 0.006%, respectively. The LRE risk of lean MASLD was significantly higher than that of normal liver control (adjusted hazard ratio [aHR]: 5.94, 95% confidence interval [CI]: 3.95–8.92) but comparable to that of non-lean MASLD (aHR: 1.35, 95% CI: 0.87–2.08). By contrast, for CVEs, the non-lean MASLD group exhibited a higher 5-year cumulative incidence rate (0.779%) than the lean MASLD (0.600%) and normal liver control (0.254%) groups. The lean MASLD group had a reduced risk of CVEs compared with the non-lean MASLD group (aHR, 0.73; 95% CI: 0.64–0.84), and comparable risk of CVEs to the normal liver control group (aHR, 0.99; 95% CI: 0.88–1.12).

Conclusion

Lean MASLD exhibits a similar LRE risk and a lower CVE risk to non-lean MASLD. Therefore, follow-up and treatment strategies should be tailored to the specific MASLD condition.

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瘦型和非瘦型代谢功能障碍相关脂肪肝的自然病史

摘要背景有关瘦型代谢功能障碍相关性脂肪性肝病（MASLD）预后的矛盾证据引发了大量疑问。目的本研究旨在通过对一个庞大的亚洲队列进行全面分析，阐明瘦型代谢功能障碍相关性脂肪性肝病的预后。方法本研究使用了一个全国性的人口数据库，分析了 290 万名患者。主要终点是瘦型MASLD患者、非瘦型MASLD患者和正常肝脏对照组的肝脏相关事件（LREs）和心血管事件（CVEs）。结果中位观察期为 4.2 年。瘦型MASLD组、非瘦型MASLD组和正常肝对照组的5年LRE发生率分别为0.065%、0.039%和0.006%。瘦型MASLD的LRE风险明显高于正常肝对照组（调整后危险比[aHR]：5.94，95%置信区间[CI]：3.95-8.92），但与非瘦型MASLD相当（aHR：1.35，95%置信区间[CI]：0.87-2.08）。相比之下，就CVEs而言，非瘦型MASLD组的5年累积发病率（0.779%）高于瘦型MASLD组（0.600%）和正常肝对照组（0.254%）。与非瘦型 MASLD 组相比，瘦型 MASLD 组的 CVE 风险较低（aHR，0.73；95% CI：0.64-0.84），与正常肝对照组的 CVE 风险相当（aHR，0.99；95% CI：0.88-1.12）。结论精益型 MASLD 的 LRE 风险与非精益型 MASLD 相似，CVE 风险较低。因此，应根据 MASLD 的具体情况制定相应的随访和治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.