Abstract：
OBJECTIVE: Recently, metabolic dysfunction-associated steatotic liver disease (MASLD) has been introduced. However, research on this new nomenclature and definition remains limited. This study aims to assess the impact of cardiometabolic risk factors and alcohol consumption on all-cause mortality in MASLD and its subgroups.
RESULTS: We included 2408 participants with MASLD in NHANES III and their linked mortality through 2019. MASLD patients were divided into two groups based on alcohol consumption: Pure MASLD and MetALD. The Cox proportional hazard model was used to assess the association between factors and all-cause mortality. During the median 26.0-year follow-up, there were 1040 deaths. The multivariable Cox regression analysis revealed a significant increase of over two-fold in the all-cause mortality rate among patients with four or more cardiometabolic risk factors compared to those with only one. When focusing on each component of cardiometabolic risk factors individually, only diabetes and hypertension were significantly associated with all-cause mortality (p < 0.05). In a subgroup analysis, each additional cardiometabolic factor was linked to an increase in all-cause mortality in both pure MASLD (hazard ratio 1.16; 95% CI 1.06-1.28; p = 0.002) and MetALD (HR 1.77; 95% CI 1.26-2.49; p = 0.001). Notably, an elevation in alcohol consumption was significantly associated with an increase in all-cause mortality rate only in the MetALD (p < 0.001).
CONCLUSIONS: This study found that the presence of diabetes or hypertension was significantly associated with all-cause mortality. We also explored the different impacts of these factors and alcohol consumption within MASLD subgroups.
RESULTS: We included 2408 participants with MASLD in NHANES III and their linked mortality through 2019. MASLD patients were divided into two groups based on alcohol consumption: Pure MASLD and MetALD. The Cox proportional hazard model was used to assess the association between factors and all-cause mortality. During the median 26.0-year follow-up, there were 1040 deaths. The multivariable Cox regression analysis revealed a significant increase of over two-fold in the all-cause mortality rate among patients with four or more cardiometabolic risk factors compared to those with only one. When focusing on each component of cardiometabolic risk factors individually, only diabetes and hypertension were significantly associated with all-cause mortality (p < 0.05). In a subgroup analysis, each additional cardiometabolic factor was linked to an increase in all-cause mortality in both pure MASLD (hazard ratio 1.16; 95% CI 1.06-1.28; p = 0.002) and MetALD (HR 1.77; 95% CI 1.26-2.49; p = 0.001). Notably, an elevation in alcohol consumption was significantly associated with an increase in all-cause mortality rate only in the MetALD (p < 0.001).
CONCLUSIONS: This study found that the presence of diabetes or hypertension was significantly associated with all-cause mortality. We also explored the different impacts of these factors and alcohol consumption within MASLD subgroups.
摘要：
目标：最近，介绍了代谢功能障碍相关的脂肪变性肝病(MASLD).然而,对这一新的术语和定义的研究仍然有限。本研究旨在评估心脏代谢危险因素和饮酒对MASLD及其亚组全因死亡率的影响。
结果：我们纳入了2408名NHANESIII患者的MASLD和他们到2019年的相关死亡率。根据饮酒情况将MASLD患者分为两组：纯MASLD和MetALD。Cox比例风险模型用于评估因素与全因死亡率之间的关联。在中位数26.0年的随访期间，有1040人死亡。多变量Cox回归分析显示，与仅有一个的患者相比，具有四个或更多心脏代谢危险因素的患者的全因死亡率显着增加了两倍以上。当单独关注心脏代谢危险因素的每个组成部分时，只有糖尿病和高血压与全因死亡率显著相关(p<0.05).在亚组分析中，在纯MASLD(风险比1.16;95%CI1.06~1.28;p=0.002)和MetALD(HR1.77;95%CI1.26~2.49;p=0.001)中,每个额外的心脏代谢因子均与全因死亡率增加相关.值得注意的是,仅在MetALD中,饮酒量升高与全因死亡率升高显著相关(p<0.001).
结论：本研究发现糖尿病或高血压的存在与全因死亡率显著相关。我们还探讨了MASLD亚组中这些因素和饮酒的不同影响。
结果：我们纳入了2408名NHANESIII患者的MASLD和他们到2019年的相关死亡率。根据饮酒情况将MASLD患者分为两组：纯MASLD和MetALD。Cox比例风险模型用于评估因素与全因死亡率之间的关联。在中位数26.0年的随访期间，有1040人死亡。多变量Cox回归分析显示，与仅有一个的患者相比，具有四个或更多心脏代谢危险因素的患者的全因死亡率显着增加了两倍以上。当单独关注心脏代谢危险因素的每个组成部分时，只有糖尿病和高血压与全因死亡率显著相关(p<0.05).在亚组分析中，在纯MASLD(风险比1.16;95%CI1.06~1.28;p=0.002)和MetALD(HR1.77;95%CI1.26~2.49;p=0.001)中,每个额外的心脏代谢因子均与全因死亡率增加相关.值得注意的是,仅在MetALD中,饮酒量升高与全因死亡率升高显著相关(p<0.001).
结论：本研究发现糖尿病或高血压的存在与全因死亡率显著相关。我们还探讨了MASLD亚组中这些因素和饮酒的不同影响。
