Cardiometabolic burden is linked to CVD and death in MASLD
In 72,922 adults with MASLD, each extra risk factor carried a hazard ratio of 1.17 for incident CVD and 1.09 for direct death.
Frontiers in Nutrition
A prospective cohort study evaluated 72,922 UK adults with metabolic dysfunction-associated steatotic liver disease over a median follow-up of 15.9 years. Researchers used multistate models to assess transitions from baseline to incident cardiovascular disease, death without prior cardiovascular disease, and death after cardiovascular disease. Over the follow-up, 15,352 participants developed cardiovascular disease, 4,273 died without prior cardiovascular disease, and 4,228 died after cardiovascular disease.
Each additional cardiometabolic risk factor was associated with higher risks of incident cardiovascular disease (hazard ratio 1.17), death without cardiovascular disease (hazard ratio 1.09), and death after cardiovascular disease (hazard ratio 1.13). Associations with incident cardiovascular disease were stronger during early follow-up, whereas mortality-related links became more apparent over longer follow-up. These associations were also stronger among participants younger than 60 years.
Why it matters
The results suggest that greater cardiometabolic burden is associated with progressive stages of cardiovascular disease and mortality in MASLD, pointing to adults under 60 as a potential priority group for sustained risk surveillance.
Caveats
Because this study is observational, it cannot establish a causal relationship between risk factor burden and disease transitions. The findings also reflect an adult cohort from the UK and may not generalize across all populations.
The paper
Bengbu Medical College · Zhejiang Chinese Medical University
Frontiers in Nutrition · 18 Sep 2026