A simpler definition of MAFLD precisely predicts incident metabolic diseases: a 7-year cohort study

• Published in: Hepatology international Vol. 17; no. 5; pp. 1182 - 1191
• Main Authors: Xie, Jiarong, Xu, Lei, Huang, Hangkai, Chen, Yishu, Wang, Jinghua, Li, Youming, Yu, Chaohui, Xu, Chengfu
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.10.2023; Springer Nature B.V
• Subjects: Arteriosclerosis; Atherosclerosis; Cohort analysis; Cohort Studies; Colorectal Surgery; Criteria; Diabetes Mellitus, Type 2 - epidemiology; Fatty liver; Hepatology; Humans; Hypertension; Hypertension - epidemiology; Liver; Liver diseases; Medicine; Medicine & Public Health; Metabolic Diseases - epidemiology; Metabolic disorders; Metabolic syndrome; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Original Article; Surgery; Hypertension; Body mass index; metabolic dysfunction-associated fatty liver disease; Metabolic dysfunction; Cohort; Fasting plasma glucose; Nonalcoholic fatty liver disease; Type 2 diabetes mellitus; Carotid atherosclerotic plaque; Criteria
• ISSN: 1936-0533; 1936-0541
• DOI: 10.1007/s12072-023-10558-1

Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is a novel definition proposed in 2020 with a relatively complex set of criteria. Thus, simplified criteria that are more applicable are required. This study aimed to develop a simplified set of criteria for identifying MAFLD and predicting MAFLD-related metabolic diseases. Methods We developed a simplified set of metabolic syndrome-based criteria for MAFLD, and compared the performance of the simplified criteria with that of the original criteria in predicting MAFLD-related metabolic diseases in a 7-year follow-up. Results In the 7-year cohort, a total of 13,786 participants, including 3372 (24.5%) with fatty liver, were enrolled at baseline. Of the 3372 participants with fatty liver, 3199 (94.7%) met the MAFLD-original criteria, 2733 (81.0%) met the simplified criteria, and 164 (4.9%) were metabolic healthy and met neither of the criteria. During 13,612 person-years of follow-up, 431 (16.0%) fatty liver individuals newly developed T2DM, with an incidence rate of 31.7 per 1000 person-years. Participants who met the simplified criteria had a higher risk of incident T2DM than those who met the original criteria. Similar results were observed for incident hypertension, and incident carotid atherosclerotic plaque. Conclusion The MAFLD-simplified criteria are an optimized risk stratification tool for predicting metabolic diseases in fatty liver individuals.