BMC Med. 2023;21(1):4.

Lean or diabetic subtypes predict increased all-cause and disease-specific mortality in metabolic-associated fatty liver disease.

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제1저자 정고은, 유수종 · 교신저자 한경도, 조은주

PMID 36600263 PMC9814304 DOI 10.1186/s12916-022-02716-3 IF 8.7 소화기내과

소속 (10)

Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-No, Jongno-Gu, Seoul, 03080, Republic of Korea.
Department of Gastroenterology and Hepatology, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-Do, Republic of Korea.
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Republic of Korea.
Department of Biomedicine and Health Science, Catholic University, Seoul, Republic of Korea.
Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation and Department of Digital Health, Samsung Advanced Institute for Health Science, Seoul, Republic of Korea.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea. hkd917@naver.com.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-No, Jongno-Gu, Seoul, 03080, Republic of Korea. creatioex@gmail.com.

Abstract

BACKGROUND Metabolic-associated fatty liver disease (MAFLD) encompasses diverse disease groups with potentially heterogeneous clinical outcomes. We investigated the risk of all-cause and disease-specific mortality in MAFLD subgroups.

METHODS Using the Korean National Health Insurance Service database, participants were divided into four subgroups: no MAFLD, MAFLD-diabetes, MAFLD-overweight/obese, and MAFLD-lean. Hazard ratios (HRs) and 95% confidence interval (CI) values for all-cause and disease-specific mortality according to MAFLD subgroups were analyzed using Cox proportional hazards models.

RESULTS Among 9,935,314 participants, those with MAFLD-diabetes showed the highest risk of all-cause and disease-specific mortality. The HRs (95% CI) for all-cause mortality were 1.61 (1.59-1.63), 1.36 (1.34-1.38), and 1.19 (1.18-1.20) in the MAFLD-diabetes, MAFLD-lean, and MAFLD-overweight/obese groups, respectively. The magnitude of cardiovascular disease and cancer-related risk showed the same pattern. The risk of liver-related mortality in the MAFLD-lean group (HR: 2.84, 95% CI: 2.72-2.97) was comparable with that in the MAFLD-diabetes group (HR: 2.85, 95% CI: 2.75-2.95). When stratified by body mass index, liver-related mortality was the highest in MAFLD-lean individuals in the underweight group (HR, 5.03, 95% CI: 4.23-5.97).

CONCLUSIONS The MAFLD-lean and MAFLD-diabetes groups had a higher risk of all-cause and disease-specific mortality than did the MAFLD-overweight/obese group. Classifying MAFLD subgroups based on metabolic phenotypes might help risk stratification of patients with MAFLD.

Keywords

LeanMetabolic dysfunctionMortalitySteatosis

Figures

**Fig. 1** Flow chart of the study population enrollment. BMI, body mass index; DM, diabetes mellitus; MAFLD, metabolic-associated fatty liver disease

그림 출처: PubMed Central 공개 논문 (PMC9814304)

Conflict of interest statement

The authors declare that they have no competing interests.

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