한빛사논문
- 조회486
Joon Ho Moon a,b,f, Seogsong Jeong c,f, Heejoon Jang a,d, Bo Kyung Koo a,e, Won Kim a,d
aDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
bDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
cDepartment of Biomedical Informatics, CHA University School of Medicine, Seongnam, South Korea
dDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
eDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
fThese authors contributed equally to this work.
Corresponding author : Won Kim
Abstract
Background
The various subcategories under the overarching term of steatotic liver disease (SLD) have been recently proposed by the nomenclature consensus group and endorsed by international academic liver societies. Our aim was to investigate the association between each subtype of SLD and incident cardiovascular disease (CVD) in a nationwide Korean cohort.
Methods
From a nationwide health screening database from Korea, 351,068 individuals aged 47–86 years between January 1, 2009 and December 31, 2010 were included and followed until December 31, 2019 for a median of 9.0 years. Individuals were categorised into no SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). Hepatic steatosis was defined as fatty liver index ≥60. The primary outcome was a composite CVD, which includes non-fatal and fatal myocardial infarction and stroke. The subdistribution hazard ratio (SHR) was calculated using the Fine–Gray model with treating non-CVD-related death as a competing risk.
Findings
There were 199,817 male (56.9%) and 151,251 female (43.1%) with a median age of 55 years (interquartile range, 50–61). The prevalence of no SLD, MASLD, MetALD, and ALD was 44.3%, 47.2%, 6.4%, and 2.1%, respectively; and the incidence rate of CVD in each subcategory was 6.2, 8.5, 8.5, and 9.6 per 1000 person-years, respectively. MASLD (SHR, 1.19; 95% confidence interval [CI], 1.15–1.24), MetALD (SHR, 1.28; 95% CI, 1.20–1.36), and ALD (SHR, 1.29; 95% CI, 1.18–1.41) increased the risk of CVD compared to no SLD, which increment was in consecutive order (Ptrend < 0.001).
Interpretation
Individuals with MASLD, MetALD, or ALD are at an increased risk of developing incident CVD. Higher risk of CVD observed in MetALD compared to MASLD suggests the additive impact of alcohol consumption in conjunction with cardiometabolic risk factors on CVD development. These findings support and validate the utility of the new consensus criteria for SLD in predicting CVD.
논문정보
- Research article
- 2023년 11월 (BRIC 등록일 2023-11-20)
- 국내 연구진
- 의약학 > 의약학 기타
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