Metabolic Dysfunction-Associated Fatty Liver Disease in Chronic Obstructive Pulmonary Disease Patients: Insights From Vietnam.

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) affects approximately 38.7% of individuals globally and potentially leads to cirrhosis and hepatocellular carcinoma. This study aims to investigate the prevalence, characteristics, and impact of MAFLD on the frequency of exacerbations in chronic obstructive pulmonary disease (COPD) patients in Vietnam.

Methods: This cross-sectional descriptive study involved stable COPD patients, and using FibroScan to detect fatty liver while applying the 2020 Asian Pacific Association for the Study of the Liver criteria for a MAFLD diagnosis.

Results: Of the 168 COPD patients, 48.8% were diagnosed with MAFLD. Patients with MAFLD had significantly worse lung function, with a lower forced expiratory volume in 1 second (57.2% versus 67.0%, p=0.002) and forced vital capacity (80.8% versus 88.1%, p=0.009), compared to those without MAFLD. The frequency of exacerbations was higher in the MAFLD group, with 46.3% experiencing ≥2 exacerbations in the previous year, compared to 30.2% in the non-MAFLD group (p=0.032). Elevated controlled attenuation parameter (CAP) scores (>289dB/m) were strongly associated with frequent exacerbations in the previous year (odds ratio [OR] 5.64, p=0.001). MAFLD was also identified as an independent factor increasing the risk of exacerbation (OR 3.64, p=0.014).

Conclusion: Nearly half of the COPD patients were diagnosed with MAFLD. MAFLD is associated with worse lung function and an increased frequency of exacerbations in the past year. Elevated CAP scores were found to be a significant risk factor for frequent exacerbations in the past year. MAFLD is an independent risk factor for exacerbations in COPD patients.