Dynamics of Cardiometabolic Risk Factors Are Linked to the Risk of Hypertension and Diabetes in MASLD

This study investigates the impact of cardiometabolic risk factors (CMRF) on the prevalence and incidence of hypertension (HTN) and diabetes mellitus (DM) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and nonsteatotic liver disease (non-SLD), using both cross-sectional and longitudinal data. A total of 32,569 Taiwanese adults without viral hepatitis or significant alcohol consumption who underwent health checkups from 1999 to 2013 were analyzed cross-sectionally. Among them, 27,109 individuals free of HTN and DM at baseline and within 1 year of enrollment were followed longitudinally. Participants were classified into four groups based on hepatic steatosis assessed by ultrasound and presence of CMRF: healthy control (non-SLD/CMRF-), simple SLD (SLD/CMRF-), non-SLD/CMRF+, and MASLD. MASLD patients exhibited markedly higher annual incidence rates of HTN and DM (19.7 and 6.3 per 1000 person-years) compared to non-SLD individuals (HTN: 9.0; DM: 0.6 per 1000 person-years). The risk of incident HTN and DM increased progressively with the number of CMRF, with adjusted hazard ratios (aHR) ranging from 2.02 to 15.53 for HTN and from 2.92 to 82.38 for DM. Regression of cardiometabolic dysfunction decreased the risk of HTN and/or DM, and vice versa. The presence of CMRF significantly increased the likelihood of developing HTN and DM in both SLD and non-SLD groups, with aHRs up to 7.48 for HTN and 15.38 for DM. In conclusion, MASLD is strongly associated with increased prevalence and incidence of HTN and DM, and the burden and trajectory of CMRF critically modulate these risks.

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Publication Details

Journal
The Kaohsiung Journal of Medical Sciences
Published
2025-07-12
DOI
https://doi.org/10.1002/kjm2.70077
Citations
1
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
1.35

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article

Dynamics of Cardiometabolic Risk Factors Are Linked to the Risk of Hypertension and Diabetes in MASLD

Meng‐Hsuan Hsieh, Pei‐Chien Tsai, Wan‐Long Chuang, Ming‐Yen Hsieh et al.
1 citations
The Kaohsiung Journal of Medical Sciences
Liver Disease Diagnosis and Treatment
1.35
article

Dynamics of Cardiometabolic Risk Factors Are Linked to the Risk of Hypertension and Diabetes in MASLD

Meng‐Hsuan Hsieh, Pei‐Chien Tsai, Wan‐Long Chuang, Ming‐Yen Hsieh, Wei‐Ting Chang, Chia‐Yen Dai, Jee‐Fu Huang, Chih‐Wen Wang, Chi‐Kung Ho, Ming‐Lun Yeh, Chung‐Feng Huang, Po‐Cheng Liang, Kuan‐Ta Wu, Ming‐Lung Yu, Yu‐Ju Wei, Vincent Wai‐Sun Wong, Yi‐Yu Chen, Ping‐Tsung Shih, Chin‐I Shih, Jeng‐Fu Yang, Yi‐Hung Lin, Ya‐Yun Cheng
article en
1 citations

Abstract

This study investigates the impact of cardiometabolic risk factors (CMRF) on the prevalence and incidence of hypertension (HTN) and diabetes mellitus (DM) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and nonsteatotic liver disease (non-SLD), using both cross-sectional and longitudinal data. A total of 32,569 Taiwanese adults without viral hepatitis or significant alcohol consumption who underwent health checkups from 1999 to 2013 were analyzed cross-sectionally. Among them, 27,109 individuals free of HTN and DM at baseline and within 1 year of enrollment were followed longitudinally. Participants were classified into four groups based on hepatic steatosis assessed by ultrasound and presence of CMRF: healthy control (non-SLD/CMRF-), simple SLD (SLD/CMRF-), non-SLD/CMRF+, and MASLD. MASLD patients exhibited markedly higher annual incidence rates of HTN and DM (19.7 and 6.3 per 1000 person-years) compared to non-SLD individuals (HTN: 9.0; DM: 0.6 per 1000 person-years). The risk of incident HTN and DM increased progressively with the number of CMRF, with adjusted hazard ratios (aHR) ranging from 2.02 to 15.53 for HTN and from 2.92 to 82.38 for DM. Regression of cardiometabolic dysfunction decreased the risk of HTN and/or DM, and vice versa. The presence of CMRF significantly increased the likelihood of developing HTN and DM in both SLD and non-SLD groups, with aHRs up to 7.48 for HTN and 15.38 for DM. In conclusion, MASLD is strongly associated with increased prevalence and incidence of HTN and DM, and the burden and trajectory of CMRF critically modulate these risks.

The Kaohsiung Journal of Medical SciencesVol. 41(12)
Tri-Service General Hospital (TW), National Sun Yat-sen University (TW), Kaohsiung Medical University (TW), Chinese University of Hong Kong (HK), Kaohsiung Medical University Chung-Ho Memorial Hospital (TW), Chi Mei Medical Center (TW), National Defense Medical Center (TW)
National Sun Yat-sen University, Ministry of Education of the People's Republic of China, Sun Yat-sen University, Ministry of Education, India, Kaohsiung Medical University, Taiwan Liver Research Foundation, National Science and Technology Council
Good health and well-being
Openalex Percentile: Top 18%
Liver Disease Diagnosis and Treatment
1.35
DOIOpen Access PDFOpenAlex
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