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Association of metabolic dysfunction-associated fatty liver disease with systemic atherosclerosis: A community-based cross-sectional study

First author：Yanli Zhang,Zhang Xia

Corresponding author：Yongjun Wang, Yan He, Yuesong Pan

Atherosclerosis; Diabetes mellitus; Fatty liver disease; Metabolic dysfunction; Polyvascular disease.

essential_information

2023-12-13

Published articles

Journal：Cardiovascular Diabetology

Publication type: Observational Study

IF(IF): 9.3

PMID: 38093371 Link To Pubmed Full text Download

Background And Purpose

Atherosclerosis, referring to the accumulation of fatty and/or fibrous material in the innermost layers of the arteries, is a hallmark for the development of cardiovascular disease and peripheral arterial disease1. Epidemiological survey showed that nearly 94% of old people had atherosclerotic plaques in at least one vascular territory, and more than 80% had multivessel atherosclerotic plaques2. In subjects with cardiovascular risk factors, 78% had at least one atherosclerotic lesion, and 53% had two or more atherosclerotic lesion3. Compared to those with single-site atherosclerosis, people with multi-site atherosclerosis have a significantly higher rate of one-year cardiovascular event, increasing from 12% (single site) to 21% (two sites) and 26% (three sites)4. Therefore, atherosclerosis, especially multi-site atherosclerosis, is highly prevalent and has seriously poor outcomes.This study aimed to examine the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and systemic atherosclerosis.

Method

This cross-sectional study derived from the baseline survey of PRECISE (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) study. MAFLD was diagnosed based on the presence of metabolic dysfunction (MD) and fatty liver disease (FLD). Atherosclerotic plaques and stenosis were evaluated by vascular magnetic resonance imaging, thoracoabdominal computed tomography angiography, or Doppler ultrasound. Polyvascular disease (PolyVD) was defined as the presence of atherosclerotic stenosis in at least two vascular sites.

Conclusion

MAFLD and its subtypes of DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD. This study implicated that FLD might be a potential target of intervention for reducing the deleterious effects of MAFLD on systemic atherosclerosis

Main results

This study included 3047 participants, with the mean age of 61.2 ± 6.7 years and 46.6% of male (n = 1420). After adjusting for potential confounders, MAFLD was associated with higher extent of plaques (cOR, 2.14, 95% CI 1.85-2.48) and stenosis (cOR, 1.47, 95% CI 1.26-1.71), and higher odds of presence of PolyVD (OR, 1.55, 95% CI 1.24-1.94) as compared with Non-MAFLD. In addition, DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD (All P < 0.05). However, lean-MAFLD was only associated with the extent of atherosclerotic plaques (cOR, 1.63, 95% CI 1.14-2.34). As one component of MAFLD, FLD per se was associated with the extent of plaques and stenosis in participants with MAFLD. Furthermore, FLD interacted with MD to increase the odds of presence of systemic atherosclerosis (P for interaction ≤ 0.055).