Longitudinal Clinical Outcomes and Mortality from Steatotic Liver Disease: A Meta-Analysis

Do Han Kim, Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: dohan.kim@mountsinai.org.
Donghyun Ko, Department of Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, CT, USA. Electronic address: rhehdgus1996@gmail.com.
Pojsakorn Danpanichkul, Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA. Electronic address: pojsakorndan@gmail.com.
Glenn Jun Ho, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: 2711glenn@gmail.com.
Faith Xin Tan, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: faithtan@u.nus.edu.
N Apoorva Sasikumar, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: e1354047@u.nus.edu.
Ethan Kai Tham, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: ethanthamkj@gmail.com.
Daniel Q. Huang, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital Singapore, Singapore. Electronic address: daniel_huang@nus.edu.sg.
Nicholas Syn, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: nicholassyn@gmail.com.
Ming-Hua Zheng, MAFLD Research Centre, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.
Takumi Kawaguchi, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan. Electronic address: takumi@med.kurume-u.ac.jp.
Yoshio Sumida, Graduate School of Healthcare Management, International University of Healthcare and Welfare, Tokyo, Japan. Electronic address: sumida.yoshio.500@mail.aichi-med-u.ac.jp.
Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. Electronic address: nakajima-tky@umin.ac.jp.
Hirokazu Takahashi, Division of Metabolism and Endocrinology, Department of Medicine, Faculty of Medicine, Saga University, Saga, Japan. Electronic address: takahas2@cc.saga-u.ac.jp.
Mazen Noureddin, Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA. Electronic address: NoureddinMD@houstonresearchinstitute.com.
Cheng Han Ng, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital Singapore, Singapore. Electronic address: chenhanng@gmail.com.
Mark D. Muthiah, Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital Singapore, Singapore. Electronic address: mdcmdm@nus.edu.sg.
Karn Wijarnpreecha, Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA; BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA. Electronic address: dr.karn.wi@gmail.com.

Document Type

Article

Publication Title

The American journal of medicine

Abstract

INTRODUCTION: The updated consensus introduces "steatotic liver disease" as an umbrella term for all patients with hepatic steatosis, with specific subtypes such as metabolic dysfunction-associated steatotic liver disease (MASLD), MetALD (MASLD with moderate alcohol intake), and alcohol-associated liver disease. Understanding the characteristics and long-term outcomes of these subtypes is essential. METHODS: A systematic review and meta-analysis examined studies published between January 2023 and August 2024 in MEDLINE and EMBASE on liver-related events, cardiovascular outcomes, and mortality across steatotic liver disease subtypes. RESULTS: A total of 13 studies, involving 17.6 million patients were included. Of these, 6.8 million individuals were diagnosed with steatotic liver disease. Subtype analysis revealed a significant increase in liver-related events and composite cardiovascular outcomes across all steatotic liver disease subtypes compared to non-steatotic liver disease. Patients with MetALD and alcohol-associated liver disease were associated with a higher risk of all-cause mortality when compared to non-steatotic liver disease. Compared to MASLD, patients with MetALD and alcohol-associated liver disease significantly elevated the risk of liver-related events and individuals with alcohol-associated liver disease were associated with increased risk of all-cause mortality. Sensitivity analysis demonstrated that certain mortality outcomes were no longer significant. CONCLUSION: Individuals across steatotic liver disease face an elevated risk of liver-related events, liver cancer, and cardiovascular outcomes. For liver-related events, the risk is progressively higher across MASLD, MetALD, and alcohol-associated liver disease, respectively. Misclassification may be introduced when using different diagnostic methods, leading to changes in outcomes. These findings validate the impact of the new classification in predicting outcomes.

DOI

10.1016/j.amjmed.2025.04.027

Publication Date

4-30-2025

Identifier

40316227 (pubmed); 10.1016/j.amjmed.2025.04.027 (doi); S0002-9343(25)00249-9 (pii)

This document is currently not available here.

Share

COinS