Meta-analytical quantification of the excess risk of developing fatal and nonfatal CVD events, permanent atrial fibrillation, new-onset heart failure or extrahepatic cancers in middle-aged individuals with MASLD
| Author(s), year, (ref) | Study characteristics | Study outcomes | Random-effects HRs (95% CI) |
| Fatal and nonfatal CVD events | |||
| Mantovani et al, 202115 | 36 longitudinal cohort studies involving a total of about 5.8 million individuals; median follow-up of 6.5 years | Any fatal or nonfatal CVD events, n=36 studies | 1.45 (1.31 to 1.61) |
| Fatal CVD events (only), n=12 studies | 1.30 (1.08 to 1.56) | ||
| Nonfatal CVD events (only), n=13 studies | 1.40 (1.20 to 1.64) | ||
| Fatal and nonfatal CVD events (combined endpoint), n=11 studies | 1.81 (1.39 to 2.36) | ||
| Subgroup analyses in patients with ‘more severe’ MASLD (MASLD with increasing severity of fibrosis assessed by histology or fibrosis scores) | Fatal CVD events (only), n=4 studies | 2.03 (1.17 to 3.54) | |
| Nonfatal CVD events (only), n=2 studies | 2.30 (1.20 to 4.42) | ||
| Fatal and nonfatal CVD events (combined endpoint), n=6 studies | 2.54 (1.73 to 3.73) | ||
| Permanent atrial fibrillation | |||
| Cai et al, 202024 | 6 longitudinal cohort studies involving a total of 614 673 individuals; median follow-up of 10 years | Incident atrial fibrillation, n=6 studies | 1.19 (1.04 to 1.31) |
| Subgroup analyses in patients with ‘more severe’ MASLD | Not enough data available for analysis | Not available | |
| Heart failure | |||
| Mantovani et al, 202225 | 11 longitudinal cohort studies involving a total of about 12.2 million individuals; median follow-up of 10 years | Incident heart failure, n=11 studies | 1.50 (1.34 to 1.67) |
| Subgroup analyses in patients with ‘more severe’ MASLD (MASLD with increasing severity of fibrosis assessed by histology or fibrosis scores) | Incident heart failure, n=2 studies | 1.76 (0.75 to 4.36) | |
| Extrahepatic cancers | |||
| Mantovani et al, 202230 | 10 longitudinal cohort studies involving a total of 182 202 individuals; median follow-up of 5.8 years | Incident oesophagus cancer, n=5 studies | 1.93 (1.19 to 3.12) |
| Incident stomach cancer n=6 studies | 1.81 (1.19 to 2.75) | ||
| Incident pancreas cancer, n=3 studies | 1.84 (1.23 to 2.74) | ||
| Incident colorectal cancer, n=8 studies | 1.64 (1.24 to 2.19) | ||
| Incident thyroid cancer, n=2 studies | 2.63 (1.27 to 5.45) | ||
| Incident lung cancer, n=5 studies | 1.30 (1.14 to 1.48) | ||
| Incident urinary system cancer, n=4 studies | 1.33 (1.04 to 1.70) | ||
| Incident breast cancer, n=4 studies | 1.39 (1.13 to 1.71) | ||
| Incident female genital organ cancer, n=4 studies | 1.62 (1.13 to 2.32) | ||
| Incident prostate cancer, n=5 studies | 1.16 (0.82 to 1.64) | ||
| Incident haematological cancers, n=2 studies | 1.47 (0.69 to 3.12) | ||
| Subgroup analyses in patients with ‘more severe’ MASLD | Not enough data available for analysis | Not available | |
CVD, cardiovascular disease; MASLD, metabolic dysfunction-associated steatotic liver disease.