Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD
- PMID: 34033923
- DOI: 10.1016/j.cgh.2021.05.029
Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD
Abstract
Background & aims: Metabolic dysfunction-associated fatty liver disease (MAFLD) establishes new criteria for diagnosing fatty liver disease independent of alcohol intake and concomitant viral hepatitis infection. However, the long-term outcomes of patients with MAFLD are sparse. We aimed to describe the characteristics and long-term survival of persons meeting criteria for nonalcoholic fatty liver disease (NAFLD) only (non-MAFLD NAFLD), for both NAFLD and MAFLD (NAFLD-MAFLD), and for MAFLD only (non-NAFLD MAFLD).
Methods: Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, 2997 participants with fatty liver identified via ultrasound were categorized into 3 distinct groups: non-MAFLD NAFLD, NAFLD-MAFLD, and non-NAFLD MAFLD.
Results: Participants in the NAFLD-MAFLD and non-NAFLD MAFLD groups were older, had more metabolic traits and higher mean liver enzymes. Nearly 8% of participants in the non-NAFLD MAFLD group had advanced fibrosis (Fibrosis-4 index >2.67), while only 1.3% and 1.9% in the NAFLD-MAFLD and non-MAFLD NAFLD groups did, respectively (P < .0001). Non-NAFLD MAFLD participants had the highest cumulative incidence of all-cause mortality (26.2%) followed by those with NAFLD-MAFLD then non-MAFLD NAFLD participants (21.1% and 10.6%, respectively; P < .0001). Similar findings were observed for cardiovascular disease-related and other-cause (noncardiovascular disease, noncancer) mortality. Non-NAFLD MAFLD was independently associated with all-cause mortality compared with non-MAFLD NAFLD (adjusted hazard ratio, 2.4; 95% confidence interval, 1.2-4.6; P = .01).
Conclusions: MAFLD criteria identified a significant group of people with more comorbidities and worse prognosis compared with those with NAFLD only. These criteria should be considered in the general population to identify high-risk groups for early interventions.
Keywords: Fatty Liver; MAFLD; Mortality Outcomes; NAFLD.
Copyright © 2021 AGA Institute. Published by Elsevier Inc. All rights reserved.
Similar articles
-
Comparison of MAFLD and NAFLD diagnostic criteria in real world.Liver Int. 2020 Sep;40(9):2082-2089. doi: 10.1111/liv.14548. Epub 2020 Jul 26. Liver Int. 2020. PMID: 32478487
-
A new risk stratification strategy for fatty liver disease by incorporating MAFLD and fibrosis score in a large US population.Hepatol Int. 2022 Aug;16(4):835-845. doi: 10.1007/s12072-022-10362-3. Epub 2022 Jun 14. Hepatol Int. 2022. PMID: 35701716
-
MAFLD and risk of CKD.Metabolism. 2021 Feb;115:154433. doi: 10.1016/j.metabol.2020.154433. Epub 2020 Nov 16. Metabolism. 2021. PMID: 33212070
-
From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple?Clin Mol Hepatol. 2021 Apr;27(2):257-269. doi: 10.3350/cmh.2021.0067. Epub 2021 Mar 22. Clin Mol Hepatol. 2021. PMID: 33751877 Free PMC article. Review.
-
Nonalcoholic fatty liver disease versus metabolic-associated fatty liver disease: Prevalence, outcomes and implications of a change in name.Clin Mol Hepatol. 2022 Oct;28(4):790-801. doi: 10.3350/cmh.2022.0070. Epub 2022 May 11. Clin Mol Hepatol. 2022. PMID: 35545437 Free PMC article. Review.
Cited by
-
METS-IR/HOMA-IR and MAFLD in U.S. adults: dose-response correlation and the effect mediated by physical activity.BMC Endocr Disord. 2024 Aug 1;24(1):132. doi: 10.1186/s12902-024-01646-w. BMC Endocr Disord. 2024. PMID: 39085855
-
The Transition of Cardiovascular Disease Risks from NAFLD to MAFLD.Rev Cardiovasc Med. 2023 May 31;24(6):157. doi: 10.31083/j.rcm2406157. eCollection 2023 Jun. Rev Cardiovasc Med. 2023. PMID: 39077530 Free PMC article. Review.
-
Non-Alcoholic Fatty Liver Disease, Atherosclerosis, and Cardiovascular Disease in Asia.Rev Cardiovasc Med. 2023 Jun 14;24(6):173. doi: 10.31083/j.rcm2406173. eCollection 2023 Jun. Rev Cardiovasc Med. 2023. PMID: 39077515 Free PMC article. Review.
-
Impact of metabolic phenotype and alcohol consumption on mortality risk in metabolic dysfunction-associated fatty liver disease: a population-based cohort study.Sci Rep. 2024 Jun 3;14(1):12663. doi: 10.1038/s41598-024-63453-6. Sci Rep. 2024. PMID: 38830939 Free PMC article.
-
Metabolic dysfunction-associated fatty liver disease and heavy alcohol consumption increase mortality:A nationwide study.Hepatol Int. 2024 May 28. doi: 10.1007/s12072-024-10671-9. Online ahead of print. Hepatol Int. 2024. PMID: 38806774
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical