Cardiovascular Disease Risk and Statin Use Among Adults with Metabolic Dysfunction Associated Fatty Liver Disease |
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| Affiliation: | 1. Division of Gastroenterology, Department of Medicine, Stanford, Calif;2. Gastroenterology Section, Veterans Affairs Palo Alto Health Care System, Calif;3. Tuberculosis Control Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, Calif;4. Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, Conn;1. Division of Infectious Diseases, New York Medical College, Valhalla, NY;2. Baystate Medical Center, Springfield, Mass;1. Department of Internal Medicine, University of Florida College of Medicine Jacksonville;2. Department of Cardiology, University of Florida College of Medicine Jacksonville;1. Division of General Internal Medicine, Massachusetts General Hospital, Boston;2. Department of Internal Medicine, McLean Hospital, Belmont, Mass;3. Harvard Medical School, Boston, Mass;1. Department of Medicine and Biological Sciences, Brown University, Providence, RI;2. Brown University Library, Providence, RI;3. Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Harvard University, Cambridge, Mass;1. University of British Columbia, Vancouver, BC, Canada;2. University of Toronto, Toronto, ON, Canada |
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| Abstract: | BackgroundA leading cause of mortality in fatty liver disease is cardiovascular disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is new terminology that classifies fatty liver due to metabolic dysfunction attributable to obesity and associated complications. We evaluated atherosclerotic cardiovascular disease (ASCVD) risk and statin use in adults with MAFLD.MethodsThis was a retrospective study of the 2011-2018 National Health and Nutrition Examination Survey. Adults with MAFLD were identified using established criteria: presence of hepatic steatosis (US Fatty Liver Index>30) plus ≥1 of the following: 1) body mass index >25 kg/m2 in non-Asians or >23 kg/m2 in Asians, 2) diabetes mellitus, and 3) ≥2 metabolic risk factors. Cardiovascular disease risk was estimated using the validated 10-year ASCVD risk score. Statin use was assessed in intermediate and high 10-year ASCVD risk groups.ResultsPrevalence of MAFLD was 34.8% (95% confidence interval [CI], 33.9%-35.8%), comprising 54.4% males, 27.9% aged 65 years and older, and 38.2% non-Hispanic white. Among adults with MAFLD, 23.3% and 23.0% had intermediate and high 10-year ASCVD risk, respectively. Compared with females, males were more likely to have high 10-year ASCVD risk (28.7% vs 16.1%, adjusted odds ratio 5.24, 95% CI, 3.87-7.10, P < .01). In intermediate and high ASCVD risk groups, overall statin use was 48.3% (95% CI, 46.1-51.3).ConclusionsOver 46% of adults with MAFLD had intermediate or high 10-year ASCVD risk. Statin use was underutilized at 48.3% in those meeting statin criteria. These findings are alarming given the high cardiovascular disease risk and low statin use in this cohort. |
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