MAFLD is associated with increased all-cause mortality in low cardiovascular-risk individuals but not in intermediate to high-risk individuals |
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| Affiliation: | 1. Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China;2. Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350001, China;1. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China;2. Department of Chronic Disease Management, Taicang Center for Disease Prevention and Control, Taicing, China;3. Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, China;4. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China;5. Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, China;1. Center for Non-communicable Disease Management, Beijing Children''s Hospital, Capital Medical University, National Center for Children''s Health, Beijing, 100045, China;2. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;3. Children''s Minnesota Research Institute, Children''s Minnesota, Minneapolis, MN 55404, USA;4. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100081, China;5. Institute for Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China;6. Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong 250012, China;1. Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China;2. Department of Laboratory Medicine, Hospital of Stomatology, Jilin University, China;3. Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, Jilin University, China;4. Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Jilin University, China;5. Endoscopy Center, China-Japan Union Hospital of Jilin University, Jilin University, China;6. Imaging and Nuclear Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China;7. Department of General Surgery, China-Japan Union Hospital of Jilin University, Jilin University, China;1. Student Research Committee, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;2. Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;3. School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;4. Science and Engineering of Food Industry, Islamic Azad University of Qazvin, Qazvin, Iran;5. Department of Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran;6. School of Pharmacy and Bio Engineering, Keele University, Staffordshire, UK;7. Keele University School of Medicine, Keele University, Staffordshire, UK;8. School of Pharmacy, MCPHS University, Boston, MA, 02115, USA;1. Department of Neurology, Baoshan Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200444, China;2. Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;3. Department of Endocrinology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China |
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| Abstract: | ![]()
Background and aimsMetabolic-associated fatty liver disease (MAFLD) is increasingly recognized as a systematic disease rather than just a liver disease alone, which raises concerns about its long-term impact on different populations. This study aimed to clarify the effects of MAFLD on long-term outcomes among different cardiovascular risk-stratified populations.Methods and resultsEligible individuals in the Third National Health and Nutrition Examination Surveys (NHANES Ⅲ, 1988–1994) were enrolled. Participants were classified into low, intermediate, or high cardiovascular-risk populations according to the Framingham general equations. Kaplan-Meier survival analysis and Cox regression models were used to investigate the association between MAFLD and long-term outcomes in different cardiovascular-risk populations.A total of 8897 adults were enrolled in the final analysis. The median ages in the non-MAFLD and MAFLD groups were 44 and 49 years old, respectively. During a median follow-up of 22.8 years, a total of 2991 deaths were recorded, including 1694 deaths (30.3%) in non-MAFLD and 1297 deaths (39.2%) in MAFLD (P < 0.001). In the low cardiovascular-risk population, MAFLD individuals had increased all-cause mortality than non-MAFLD individuals (HR = 1.206, 95% CI:1.0338-1.400, P = 0.014). However, similar results were not observed in intermediate or high-cardiovascular-risk individuals. Further analysis of cause-specific mortality suggested that MAFLD was associated with higher cancer-related mortality in the low-risk population (HR = 1.313, 95% CI:1.000-1.725, P = 0.049).ConclusionsMAFLD was associated with increased all-cause mortality among individuals with low cardiovascular risk, rather than those with an intermediate or high cardiovascular risk. |
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| Keywords: | MAFLD Mortality Cardiovascular risk stratification NHANES Ⅲ Framingham general equations APRI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" aspartate-aminotransferase to platelet ratio index BMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" body mass index CVD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" cardiovascular disease FIB-4" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" fibrosis-4 index HDL-C" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" high-density lipoprotein cholesterol HR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" hazard ratios MAFLD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" metabolic-associated fatty liver disease NAFLD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0110" }," $$" :[{" #name" :" text" ," _" :" nonalcoholic fatty liver disease NFS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0120" }," $$" :[{" #name" :" text" ," _" :" NAFLD fibrosis score NHANES" },{" #name" :" keyword" ," $" :{" id" :" kwrd0130" }," $$" :[{" #name" :" text" ," _" :" National Health and Nutrition Examination Survey |
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