Frontiers in Endocrinology · Oct 30, 2026
MASLD VCTE-C Cohort: A Prospective Multicenter Study Linking Liver Fibrosis to Cardiovascular Outcomes in Patients with Metabolic Dysfunction–Associated Steatotic Liver Disease
By Young Chang, Young Kul Jung, Han Ah Lee et al.
Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is associated with increased risk of cardiovascular disease (CVD). The MASLD vibration-controlled transient elastography (VCTE)-C cohort is designed to examine the relationships among VCTE-derived hepatic measures, coronary artery calcification, and long-term cardiovascular outcomes in patients with MASLD. Methods: This prospective, multicenter observational cohort will enroll 880 patients with VCTE-defined MASLD (controlled attenuation parameter [CAP] ≥248 dB/m) across 11 tertiary hospitals in the Republic of Korea. Additional eligibility criteria include at least one of the following: (i) type 2 diabetes; (ii) prediabetes; or (iii) obesity accompanied by at least one additional cardiovascular risk factor. Baseline assessments include noninvasive surrogates for liver fibrosis (fibrosis-4 index and liver stiffness measurement by VCTE) and steatosis (CAP by VCTE), coronary artery calcium scoring by noncontrast cardiac computed tomography, cardiometabolic profiling, and 10-year cardiovascular risk estimation primarily using the PREVENT equations, with the Pooled Cohort Equations and K-CVD model applied as complementary tools. Outcomes: The primary outcome is time to the first occurrence of a four-component major adverse cardiovascular event, comprising acute myocardial infarction, stroke, cardiovascular death, or coronary revascularization. Secondary outcomes include other cardiovascular events, hepatic and renal outcomes, extrahepatic malignancy, and all-cause mortality. Participants will be followed for up to 10 years with serial VCTE; repeat coronary artery calcium scoring is planned at 5 and 10 years in eligible participants. Conclusion: The MASLD VCTE-C cohort is expected to provide prospective evidence on liver–cardiovascular relationships that may inform integrated risk assessment in patients with MASLD. (KCT0012473)