Associations of serum carotenoids with cardiovascular disease mortality among patients with metabolic dysfunction-associated steatotic liver disease.

Aim: High cardiovascular disease (CVD) mortality occurred among metabolic dysfunction-associated steatotic liver disease (MASLD) patients with few approved therapies. The aim of this study was to reveal the associations of serum carotenoid concentrations with CVD mortality among MASLD patients.

Methods: The two prospective cohort analyses included 1175 MASLD patients from the National Health and Nutrition Examination Survey (NHANES) and 1725 MASLD patients from NHANES III. CVD mortality was ascertained through December 31, 2019. Multivariable Cox proportional hazards regression analysis was carried out to evaluate the associations of serum carotenoid levels with CVD mortality.

Results: After multivariable adjustment, per one-unit increment in natural log-transformed serum β-cryptoxanthin was associated with an 85% lower risk of CVD mortality (p = 0.03) among MASLD patients aged <60 years from NHANES and a 92% lower risk of CVD mortality (p = 0.003) among MASLD patients aged <60 years from NHANES III. The adjusted HRs (95% CIs) across tertiles of serum β-cryptoxanthin concentrations were 1.00 (reference), 0.55 (0.12-2.41), 0.02 (0.002-0.24), P trend = 0.03 and 1.00 (reference), 0.47 (0.14-1.58), 0.05 (0.01-0.31), P trend = 0.002, among MASLD patients aged <60 years from NHANES and NHANES III, respectively.

Conclusions: In MASLD patients aged <60 years, high serum β-cryptoxanthin concentrations were inversely associated with CVD mortality.