Sahana Shetty, Renuka Suvarna, Vanessa Ambrose Fistus, Shivam Modi, Joseph M Pappachan
{"title":"代谢功能障碍相关脂肪性肝病和2型糖尿病的心血管影响：一项荟萃分析","authors":"Sahana Shetty, Renuka Suvarna, Vanessa Ambrose Fistus, Shivam Modi, Joseph M Pappachan","doi":"10.4254/wjh.v17.i5.105706","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the development of cardiovascular disease (CVD) and an exaggerated CVD risk is expected when both diseases co-exist. Therefore, thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.</p><p><strong>Aim: </strong>To identify the CVD and cardiovascular event (CVE) risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.</p><p><strong>Methods: </strong>A systematic review was performed by compiling data by searching PubMed, EMBASE and Cochrane Library databases. Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute (JBI) tool and RevMan 5.4 software respectively. The effect indicators for CVE and CVD risk were expressed as odds ratios (OR) and 95%CI with <i>P</i>-values < 0.05 as significant.</p><p><strong>Results: </strong>Fourteen (5 cohort and 9 cross-sectional) studies with 370013 participants were included in this review. The meta-analysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group [OR 1.28 (95%CI, 1.04-1.56) <i>P</i> = 0.02] with follow up duration ranging between 5-6 years. The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher [OR 1.47 (95%CI, 1.21-1.78) <i>P</i> = 0.0001] in T2DM with MAFLD when compared to T2DM without MAFLD. Significant heterogeneity exists due to variations in study design, methodologies, and MAFLD diagnostic criteria, which may have influenced the study's findings.</p><p><strong>Conclusion: </strong>The presence of MAFLD in T2DM increased the risk of CVE. The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD. Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"105706"},"PeriodicalIF":2.5000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149901/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cardiovascular implications of metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus: A meta-analysis.\",\"authors\":\"Sahana Shetty, Renuka Suvarna, Vanessa Ambrose Fistus, Shivam Modi, Joseph M Pappachan\",\"doi\":\"10.4254/wjh.v17.i5.105706\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the development of cardiovascular disease (CVD) and an exaggerated CVD risk is expected when both diseases co-exist. Therefore, thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.</p><p><strong>Aim: </strong>To identify the CVD and cardiovascular event (CVE) risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.</p><p><strong>Methods: </strong>A systematic review was performed by compiling data by searching PubMed, EMBASE and Cochrane Library databases. Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute (JBI) tool and RevMan 5.4 software respectively. The effect indicators for CVE and CVD risk were expressed as odds ratios (OR) and 95%CI with <i>P</i>-values < 0.05 as significant.</p><p><strong>Results: </strong>Fourteen (5 cohort and 9 cross-sectional) studies with 370013 participants were included in this review. The meta-analysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group [OR 1.28 (95%CI, 1.04-1.56) <i>P</i> = 0.02] with follow up duration ranging between 5-6 years. The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher [OR 1.47 (95%CI, 1.21-1.78) <i>P</i> = 0.0001] in T2DM with MAFLD when compared to T2DM without MAFLD. Significant heterogeneity exists due to variations in study design, methodologies, and MAFLD diagnostic criteria, which may have influenced the study's findings.</p><p><strong>Conclusion: </strong>The presence of MAFLD in T2DM increased the risk of CVE. The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD. Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.</p>\",\"PeriodicalId\":23687,\"journal\":{\"name\":\"World Journal of Hepatology\",\"volume\":\"17 5\",\"pages\":\"105706\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149901/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Hepatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4254/wjh.v17.i5.105706\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Hepatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4254/wjh.v17.i5.105706","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：代谢功能障碍相关脂肪性肝病（MAFLD）和2型糖尿病（T2DM）是心血管疾病（CVD）发展的独立危险因素，当这两种疾病共存时，CVD风险可能会增加。因此，彻底的风险分层对于根据高质量的证据为MAFLD和T2DM患者提供更好的临床实践决策非常重要。目的：在一项系统评价中，当MAFLD和T2DM共存时，确定CVD和心血管事件（CVE）的风险，为更好的临床实践决策提供信息。方法：通过检索PubMed、EMBASE和Cochrane图书馆数据库进行系统评价。分别使用Joanna Briggs Institute （JBI）工具和RevMan 5.4软件对检索研究进行质量评价和meta分析。CVE和CVD风险的影响指标以比值比（OR）和95%CI表示，p值< 0.05为显著性。结果：14项研究（5项队列研究和9项横断面研究）纳入了370013名参与者。CVE的荟萃分析显示，与非MAFLD组相比，MAFLD组T2DM发生CVE的风险更高[OR 1.28 (95%CI, 1.04-1.56) P = 0.02]，随访时间为5-6年。横断面研究的荟萃分析发现，T2DM合并MAFLD的CVD患病率高于T2DM不合并MAFLD的CVD患病率[OR 1.47 (95%CI, 1.21-1.78) P = 0.0001]。由于研究设计、方法和MAFLD诊断标准的差异，存在显著的异质性，这可能影响了研究结果。结论：T2DM患者中mld的存在增加了CVE的发生风险。伴有MAFLD的T2DM患者CVD患病率高于无MAFLD的T2DM患者。大型精心设计的多中心长期前瞻性研究是必要的，以适当地对2型糖尿病患者的心血管影响进行风险分层。
Cardiovascular implications of metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus: A meta-analysis.
Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the development of cardiovascular disease (CVD) and an exaggerated CVD risk is expected when both diseases co-exist. Therefore, thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.
Aim: To identify the CVD and cardiovascular event (CVE) risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.
Methods: A systematic review was performed by compiling data by searching PubMed, EMBASE and Cochrane Library databases. Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute (JBI) tool and RevMan 5.4 software respectively. The effect indicators for CVE and CVD risk were expressed as odds ratios (OR) and 95%CI with P-values < 0.05 as significant.
Results: Fourteen (5 cohort and 9 cross-sectional) studies with 370013 participants were included in this review. The meta-analysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group [OR 1.28 (95%CI, 1.04-1.56) P = 0.02] with follow up duration ranging between 5-6 years. The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher [OR 1.47 (95%CI, 1.21-1.78) P = 0.0001] in T2DM with MAFLD when compared to T2DM without MAFLD. Significant heterogeneity exists due to variations in study design, methodologies, and MAFLD diagnostic criteria, which may have influenced the study's findings.
Conclusion: The presence of MAFLD in T2DM increased the risk of CVE. The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD. Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
