Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Meta-analysis of 129 Studies

Kai En Chan, Elden Yen Hng Ong, Charlotte Hui Chung, Christen En Ya Ong, Benjamin Koh, Darren Jun Hao Tan, Wen Hui Lim, Jie Ning Yong, Jieling Xiao, Zhen Yu Wong, Nicholas Syn, Apichat Kaewdech, Margaret Teng, Jiong Wei Wang, Nicholas Chew, Dan Yock Young, Alfred Know, Mohammad Shadab Siddiqui, Daniel Q. Huang, Nobuharu TamakiVincent Wai Sun Wong, Christos S. Mantzoros, Arun Sanyal, Mazen Noureddin, Cheng Han Ng, Mark Muthiah

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Background & Aims: The progression of metabolic dysfunction-associated steatotic liver disease (MASLD) has been found to manifest in a series of hepatic and extrahepatic complications. A comprehensive meta-analysis of the longitudinal outcomes associated with MASLD has yet to be conducted. Methods: To investigate the longitudinal outcomes associated with MASLD, Medline and Embase databases were searched to identify original studies that evaluated the longitudinal risks of incident clinical outcomes among MASLD patients compared with non-MASLD individuals. DerSimonian Laird random-effects meta-analysis was performed. Pooled effect estimates were calculated, and heterogeneity among studies was evaluated. Results: One hundred twenty-nine studies were included in the meta-analysis. Meta-analysis revealed a significant increase in the risk of cardiovascular outcomes (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.27–1.60; P < .01), various metabolic outcomes such as incident hypertension (HR, 1.75; 95% CI, 1.46–2.08; P < .01), diabetes (HR, 2.56; 95% CI, 2.10–3.13; P < .01), pre-diabetes (HR, 1.69; 95% CI, 1.22–2.35; P < .01), metabolic syndrome (HR, 2.57; 95% CI, 1.13–5.85; P = .02), chronic kidney disease (HR, 1.38; 95% CI, 1.27–1.50; P < .01), as well as all cancers (HR, 1.54; 95% CI, 1.35–1.76; P < .01) among MASLD patients compared with non-MASLD individuals. By subgroup analysis, MASLD patients with advanced liver disease (HR, 3.60; 95% CI, 2.10–6.18; P < .01) were also found to be associated with a significantly greater risk (P = .02) of incident diabetes than those with less severe MASLD (HR, 1.63; 95% CI, 1.0–2.45; P = .02) when compared with non-MASLD. Conclusions: The present study emphasizes the association between MASLD and its clinical outcomes including cardiovascular, metabolic, oncologic, and other outcomes. The multisystemic nature of MASLD found in this analysis requires treatment targets to reduce systemic events and end organ complications.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Early online dateSep 28 2023
DOIs
StateE-pub ahead of print - Sep 28 2023

Keywords

  • Clinical Outcomes
  • Longitudinal Risks
  • Metabolic Diseases
  • Metabolic Dysfunction-Associated Steatotic Liver Disease

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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