Three Cardiometabolic Risk Factors ID'd as Having the Highest Risk for Mortality in MASLD
TUESDAY, Sept. 23, 2025 -- For patients with metabolic dysfunction-associated steatotic liver disease (MASLD), the cardiometabolic risk factors (CMRFs) of high blood pressure, glucose intolerance, and low high-density lipoprotein (HDL) cholesterol harbor the greatest risk for mortality, according to a study published online Sept. 17 in Clinical Gastroenterology and Hepatology.
Matthew Dukewich, M.D., Pharm.D., from the University of Southern California Keck School of Medicine in Los Angeles, and colleagues examined the association of individual CMRFs with all-cause mortality in U.S. adults with MASLD. A total of 21,872 adults ages 20 years and older with a Fatty Liver Index >60 and at least one CMRF were included in the study.
The researchers found that the participants had a mean body mass index (BMI) of 33.6 kg/m2 with a median of three CMRFs. Significant risks for mortality were seen for high blood pressure (adjusted hazard ratio [aHR], 1.39), glucose intolerance (aHR, 1.26), and low HDL cholesterol (aHR, 1.15) in an adjusted analysis of individual CMRFs. Compared with those with a BMI ≥25 to ≤30 kg/m2, mortality risk was significantly greater for BMI ≥35 to ≤40, ≥40 to ≤45, and ≥45 kg/m2. The number of CMRFs was associated with greater mortality risk in an age-adjusted analysis.
"MASLD is a complicated disease, and this study sheds new light on where doctors may want to focus their efforts when treating patients," senior author Norah A. Terrault, M.D., also from the University of Southern California Keck School of Medicine, said in a statement.
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