Abstract

BACKGROUND: A leading cause of mortality in fatty liver disease is cardiovascular disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is new terminology that classifies fatty liver due to metabolic dysfunction attributable to obesity and associated complications. We evaluated atherosclerotic cardiovascular disease (ASCVD) risk and statin use in adults with MAFLD.METHODS: Retrospective study of 2011-2018 National Health and Nutrition Examination Survey. Adults with MAFLD were identified using established criteria: presence of hepatic steatosis (US Fatty Liver Index>30) plus =1 of the following: (1) body mass index >25 kg/m2 in non-Asians or >23 kg/m2 in Asians, (2) diabetes mellitus, or (3) =2 metabolic risk factors. cardiovascular disease risk was estimated using the validated 10-year ASCVD risk score. Statin use was assessed in intermediate and high 10-year ASCVD risk groups.RESULTS: Prevalence of MAFLD was 34.8% (95% CI 33.9%-35.8%), comprising 54.4% men, 27.9% age =65y, and 38.2% non-Hispanic white. Among adults with MAFLD, 23.3% and 23.0% had intermediate and high 10-year ASCVD risk, respectively. Compared to women, men were more likely to have high 10-year ASCVD risk (28.7% vs. 16.1%, adjusted OR (aOR) 5.24, 95% CI 3.87-7.10, p<0.01). In intermediate and high ASCVD risk groups, overall statin use was 48.3% (95% CI 46.1-51.3).CONCLUSIONS: Over 46% of adults with MAFLD had intermediate or high 10-year ASCVD risk. Statin use was underutilized at 48.3% in those meeting statin criteria. These findings are alarming given high cardiovascular disease risk and low statin use in this cohort.

View details for DOI 10.1016/j.amjmed.2023.03.010

View details for PubMedID 37001720