Impact of cardiometabolic risk factors on hepatic fibrosis and clinical outcomes in MASLD: A population-based multi-cohort study

Understanding the impact of the five cardiometabolic risk factors (CMRFs) used in the diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) on hepatic fibrosis and long-term clinical outcomes can improve the quality of care in the general population by facilitating the identification of at-risk individuals with MASLD. In our results, although the impact of each of the five CMRFs on hepatic fibrosis and long-term clinical outcomes varied depending on the type of clinical outcomes and the characteristics of the population, impaired fasting glucose (CMRF2) consistently showed the highest risk. Patients with MASLD and CMRF2 exhibited a two-to-four times higher risk of hepatic fibrosis and liver-related events compared with those without impaired fasting glucose levels, similar to MASLD accompanied by any four CMRFs. The utilization of impaired fasting glucose (CMRF2) can raise awareness among primary care providers regarding high-risk groups at the time of MASLD diagnosis.