New definition of metabolic dysfunction-associated fatty liver disease with elevated brachial-ankle pulse wave velocity and albuminuria: a prospective cohort study

Abstract

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01–1.55) and 1.35 (95% CI 1.07–1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07–2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.

Keywords

metabolic dysfunction-associated fatty liver disease / non-alcoholic fatty liver disease / fibrosis score / brachial-ankle pulse wave velocity / albuminuria

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Acknowledgements

The investigators are grateful to all participants for their cooperation in the study. This work was supported by the grants from the National Key R&D Program of China (Nos. 2017YFC1310700, 2018YFC1311800, and 2018YFC1311705), the National Natural Science Foundation of China (Nos. 81870560, 82070880, 81941017, 81770842, 81970706, and 82022011), the National Science and Technology Major Project for “Significant New Drugs Development” (No. 2017ZX09304007), Shanghai Municipal Government (No. 18411951800), Shanghai Shenkang Hospital Development Center (Nos. SHDC12019101, SHDC2020CR1001A, and SHDC2020CR3069B), the Scientific and Technological Committee of Shanghai (No. 19411964200), Shanghai Jiao Tong University School of Medicine (No. DLY201801), Ruijin Hospital (No. 2018CR002) and Shanghai Rising-Star Program (No. 21QA1408100).

Compliance with ethics guidelines

Jialu Wang, Shanshan Liu, Qiuyu Cao, Shujing Wu, Jingya Niu, Ruizhi Zheng, Lizhan Bie, Zhuojun Xin, Yuanyue Zhu, Shuangyuan Wang, Hong Lin, Tiange Wang, Min Xu, Jieli Lu, Yuhong Chen, Yiping Xu, Weiqing Wang, Guang Ning, Yu Xu, Mian Li, Yufang Bi, and Zhiyun Zhao have no conflict of interest to declare. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11684-021-0888-8 and is accessible for authorized users.

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