Clinical outcomes of MAFLD versus NAFLD: A meta-analysis of observational studies

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2024-08-19 DOI:10.1111/liv.16075

Grazia Pennisi, Giuseppe Infantino, Ciro Celsa, Gabriele Di Maria, Marco Enea, Marco Vaccaro, Roberto Cannella, Carlo Ciccioli, Claudia La Mantia, Alessandro Mantovani, Francesco Mercurio, Herbert Tilg, Giovanni Targher, Vito Di Marco, Calogero Cammà, Salvatore Petta

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引用次数: 0

Abstract

Importance

The recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) highlights the link between hepatic steatosis and metabolic dysfunction, taking out the stigmata of alcohol.

Objective

We compared the effects of NAFLD and MAFLD definitions on the risk of overall and cardiovascular (CV) mortality, liver-related events (LRE), nonfatal CV events (CVE), chronic kidney disease (CKD), and extra-hepatic cancers (EHC).

Data Sources and Study Selection

We systematically searched four large electronic databases for cohort studies (published through August 2023) that simultaneously used NAFLD and MAFLD definitions for examining the risk of mortality and adverse CV, renal, or oncological outcomes associated with both definitions. In total, 21 eligible cohort studies were identified. Meta-analysis was performed using random-effects modelling.

Results

Compared with those with NAFLD, individuals with MAFLD had significantly higher rates of overall mortality (random-effect OR 1.12, 95% CI 1.04–1.21, p = .004) and CV mortality (random-effect OR 1.15, 95% CI 1.04–1.26, p = .004), and a marginal trend towards higher rates of developing CKD (random-effect OR 1.06, 95% CI 1.00–1.12, p = .058) and EHC events (random-effect OR 1.11, 95% CI 1.00–1.23, p = .052). We found no significant differences in the risk LREs and nonfatal CVE between MAFLD and NAFLD. Meta-regression analyses identified male sex and metabolic comorbidities as the strongest risk factors related to the risk of adverse clinical outcomes in MAFLD compared to NAFLD.

Conclusions and Relevance

Individuals with MAFLD have higher rates of overall and CV mortality and higher rates of developing CKD and EHC events than those with NAFLD, possibly due to the dysmetabolic risk profile related to MAFLD.

Abstract Image

查看原文本刊更多论文

MAFLD 与 NAFLD 的临床结果对比：观察性研究的荟萃分析。

重要性：最近，术语从非酒精性脂肪肝（NAFLD）变更为代谢功能障碍相关性脂肪肝（MAFLD）和代谢功能障碍相关性脂肪肝（MASLD），突出了肝脂肪变性与代谢功能障碍之间的联系，同时剔除了酒精的烙印：我们比较了NAFLD和MAFLD定义对总死亡率、心血管（CV）死亡率、肝脏相关事件（LRE）、非致死性CV事件（CVE）、慢性肾脏病（CKD）和肝外癌症（EHC）风险的影响：我们在四个大型电子数据库中系统检索了同时使用 NAFLD 和 MAFLD 定义的队列研究（发表至 2023 年 8 月），以研究与这两种定义相关的死亡率和不良 CV、肾脏或肿瘤结局的风险。总共确定了 21 项符合条件的队列研究。采用随机效应模型进行了元分析：与非酒精性脂肪肝患者相比，MAFLD 患者的总死亡率（随机效应 OR 1.12，95% CI 1.04-1.21，p = .004）和心血管疾病死亡率（随机效应 OR 1.15，95% CI 1.随机效应 OR 1.06，95% CI 1.00-1.12，p = .058）和 EHC 事件（随机效应 OR 1.11，95% CI 1.00-1.23，p = .052）的发生率略有上升趋势。我们发现，MAFLD 和 NAFLD 的 LRE 和非致死性 CVE 风险没有明显差异。元回归分析发现，与非酒精性脂肪肝相比，男性和代谢并发症是与 MAFLD 不良临床结局风险相关的最强风险因素：与非酒精性脂肪肝患者相比，MAFLD 患者的总死亡率和心血管疾病死亡率更高，患慢性肾脏病和心血管健康事件的比例也更高，这可能是由于 MAFLD 的代谢异常风险特征所致。

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

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.