Letter to the Editor: Elevated concurrent carotid atherosclerosis rates in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) compared to non-alcoholic fatty liver disease (NAFLD): A cross-sectional observational study

Abstract

Recent studies suggest that metabolic dysfunction-associated fatty liver disease (MAFLD) poses a greater cardiovascular risk than non-alcoholic fatty liver disease (NAFLD), particularly in relation to carotid atherosclerosis. This letter discusses findings from Chung et al., highlighting an increased prevalence of carotid atherosclerosis in MAFLD patients. However, methodological limitations such as retrospective design, single-center scope, and lack of data on confounding factors raise concerns about causality and generalizability. Emerging evidence supports MAFLD’s stronger predictive value for cardiovascular disease compared to NAFLD, with studies indicating a significantly higher incidence of subclinical atherosclerosis and cardiovascular mortality. The inclusion of metabolic risk factors in MAFLD criteria enhances its clinical relevance. Future research should adopt prospective, multi-center designs with comprehensive lifestyle and medication data to validate findings and refine screening protocols. Recognizing MAFLD’s distinct cardiovascular implications may improve early intervention strategies and patient outcomes.