Review
Copyright ©The Author(s) 2023.
World J Hepatol. Apr 27, 2023; 15(4): 477-496
Published online Apr 27, 2023. doi: 10.4254/wjh.v15.i4.477
Table 1 Studies evaluating the risk of cardiovascular disease in patients with nonalcoholic fatty liver disease and metabolic-associated fatty liver disease
Study
Number of patients
Type of study
Outcome measure
Results
Liang et al[168]6873Cohort Study with a 4.6 yr follow upAssociations of MAFLD and NAFLD with DM, CKD, and CVDMAFLD was associated with higher risks of CVD (hazard ratio 1.44; 95%CI, 1.15-1.81); Similar associations were observed for NAFLD, except for a higher incidence of DM in MAFLD patients with HBV infection and excess alcohol consumption
Wang et al[169]12183Cross-sectional study (SPECT – China)Compare the cardiovascular and renal burden between MAFLD and NAFLD patientsThe odds ratio of previous CVD was higher in patients with MAFLD. Male 1.50 (1.22,1.85) vs 1.35 (1.1, 1.66); female 1.58 (1.33,1.87) vs 1.45 (1.22, 1.72)
Zhang et al[170]19617Nationwide database studyThe burden of CKD and CVD in adults with MAFLD and NAFLDThe cardiorenal burden may be greater for MAFLD than for NAFLD
Lee et al[171]8962813Cohort study with a 10.1 yr follow up Association of MAFLD and NAFLD with CVD MAFLD patients have a higher risk of CKD when compared to NAFLD [1.43 (1.41–1.45) vs 1.09 (1.03–1.15)]
Yoneda et al[172]2452949Nationwide database study Association of MAFLD and NAFLD with CVDThe incidence rates of CVD were 2.82 (95%CI 2.64-3.01) per 1000 person-yr in the NAFLD groups and 2.69 (95%CI 2.55-2.83) per 1000 person-years in the MAFLD groups
Guerreiro et al[173]1233Retrospective cross-sectional studyCompare CVR and risk of CVD between patients with NAFLD and MAFLDIn patients with MAFLD and NAFLD, CVR was intermediate/high (36.4 and 25.7%, P = 0.209) and CVD occurred in 20.1 and 12.8% (P = 0.137) of the cases, respectively, with no influence of liver injury severity
Zhang et al[158]11673Retrospective study Compare the risk of CVD between patients with NAFLD and MAFLDMAFLD was more significant than NAFLD in medium/high 10-yr CVD risk (according to Framingham risk score) [1064 (29.92%) vs 1022 (26.37%), P < 0.005]
Wen et al[147]-Meta-analysis Investigate the risk of CVD incidence or CVD-related mortality in patients diagnosed with MAFLD and NAFLDThe incidence of CVD or CVD mortality was 1.95 times higher in the MAFLD group than in the control group. The risk of CVD or death from CVD was significantly higher in the MAFLD-only group than in the NAFLD-only group, with an RR of 2.57 (95%CI 1.41–4.71; I2 = 78%, P = 0.002)
Guo et al[174]12794Cohort study Study the relationship between MAFLD and incident CVDThe incidence of CVD in the patients with MAFLD was significantly higher than that in the non-MAFLD patients (18.38% vs 9.02%, P ≤ 0.001; aHR = 1.37, 95%CI = 1.20-1.56)
Moon et al[175]8919Cohort studyEffect of MAFLD on future mortality and CVD using a prospective community-based cohort studyT2DM in MAFLD increased the risk of both mortality (HR, 2.07; 95%CI, 1.52 to 2.81) and CVD (HR, 1.42; 95%CI, 1.09 to 1.85)
Zou et al[176]513Cross-sectional studyPrevalence of MAFLD and its relationship with CVD risks in RA patientsRA patients with MAFLD had a higher rate of CVD events (17.3% vs 9.2%) and a higher proportion of high estimated 10-yr CVD risk (55.5% vs 26.1%) than those without
Table 2 Studies evaluating the risk of chronic kidney disease in patients with non-alcoholic fatty liver disease and Metabolic dysfunction associated fatty liver disease
Study
Number of patients
Type of Study
Outcome measure
Results
Sun et al[177]12571Cross-sectional studyAssociation between MAFLD and NALFD with CKD MAFLD patients had lower GFR (74.96 ± 18.21) and higher prevalence of CKD (29.6%)
Liang et al[168]6873Cohort Study with a 4.6 yr follow upAssociations of MAFLD and NAFLD with T2DM, CKD, and CVDMAFLD was associated with a higher risk of CKD (RR 1.64; 95%CI, 1.39-1.94). Similar associations were observed for NAFLD, except for a higher incidence of DM in MAFLD patients with HBV infection and excess alcohol consumption.
Deng et al[178]4869A cross-sectional study from the NHANES database 2017 – 2018 Association between MAFLD and CKDHigher prevalence of CKD in MAFLD subjects than in non-MALFD subjects (22.2% vs 19.1%, P = 0.048)
Wang et al[169]12183Cross-sectional study (SPECT – China)Compare the cardiovascular and renal burden between MAFLD and NAFLD patientsOR of CKD was higher in males with NAFLD [CKD: 1.44 (1.05, 1.96) vs 1.56 (1.14, 2.12)] than those with MAFLD
Su et al[179]5594Cross-sectional studyAssociation between MAFLD and CKDMAFLD was independently associated with an increased risk of CKD [odds ratio (OR): 1.35, 95%CI: 1.09-1.67]. MAFLD with T2DM had significant associations with increased risk of CKD (OR: 2.85, 95%CI: 2.24-3.63), as well as increased eGFR and UACR
Hu et al[180]15010Cross-sectional studyAssociation between MAFLD and CKDMAFLD was significantly associated with a higher CKD prevalence (OR 1.715, 95%CI 1.389-2.117, P < 0.001). MAFLD alone was not an independent risk factor for CKD
Hashimoto et al[181]27371 Cross-sectional studyAssociation between FLD and MAFLD with CKDMAFLD was associated with the risk of incident CKD [adjusted hazard ratio 1.24 (1.14-1.36), P < 0.001], whereas FLD without MD was not [1.11 (0.85-1.41), P = 0.433]
Zhang et al[170]19617A retrospective nationwide cohort studyRenal burdens in adults with MAFLD and NAFLDThe cardiorenal burden may be greater for MAFLD than for NAFLD
Jung et al[161]268946A retrospective nationwide cohort study Association between MAFLD and NALFD with CKDThe adjusted hazard ratio (aHR) for incident CKD in MAFLD was 1.18 (95%CI, 1.01-1.39; P = 0.040) compared to those with NAFLD
Tanaka et al[182]13159Retrospective single-center study Associations of FL, NAFLD, and MAFLD with the development of CKDMAFLD [HR (95%CI): 1.12 (1.02-1.26), P = 0.027], but not FL or NAFLD, was an independent risk factor for incident CKD