Cardiometabolic risk factors in patients with metabolic dysfunction-associated fatty steatotic liver disease: a multicenter study PROMASLD

Cardiometabolic risk factors (CMRFs) are not only diagnostic criteria for metabolic dysfunction-associated steatotic liver disease (MASLD), but also important prognostic factors affecting the course and outcome of the disease. Real-world data on the prevalence and combination of CMRFs in large, unselected cohorts of patients with MASLD remain scarce. Objective. To study the profile of cardiometabolic risk factors in patients with metabolic dysfunction-associated steatotic liver disease in real-world settings. Materials and methods. A multicenter cross-sectional study with a retrospective component was conducted. The MASLD diagnosis was based on evidence of liver steatosis on ultrasound (US) and the presence of at least one CMRF. Anthropometric parameters, CMRFs, blood test results, abdominal ultrasound, and liver elastography data were recorded in all patients. Based on the data collected, the Fatty Liver Index (FLI) and the liver fibrosis index (Fibrosis-4 Index; FIB-4) were calculated. Results. Of the 2260 included patients, 785 patients were diagnosed with MASLD (34.7%; 58.8% females; median age: 56 [45–66] years). The most common CMRFs were overweight/obesity (n=677/785; 86.2%) and waist circumference above the reference values (n=631/785; 80.3%). In total, 6.7% of patients had only 1 CMRF. Among patients with ≥5 CMRFs, males predominated (p=0.003). The number of CMRFs correlated with patient age (ρ=0.499, p<0.001), the FLI index (ρ=0.352, p<0.001), and the FIB-4 index (ρ=0.278, p<0.001). Conclusion. Most patients with metabolic dysfunction-associated steatotic liver disease have several cardiometabolic risk factors strongly associated with changes in the liver. It highlights the need for a comprehensive assessment of metabolic status to optimize risk stratification and individualized patient management.