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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Editor-in-Chief
    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

    Deputy Editor

    Deputy Editor
    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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    All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
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Fibrotic Burden Determines Cardiovascular Risk among Subjects with Metabolic Dysfunction-Associated Fatty Liver Disease

Eugene Han1 , Yong-ho Lee2,3 , Jae Seung Lee2,4 , Hye Won Lee2,4 , Beom Kyung Kim2,4 , Jun Yong Park2,4 , Do Young Kim2,4 , Sang Hoon Ahn2,4 , Byung-Wan Lee2,3 , Eun Seok Kang2,3 , Bong-Soo Cha2,3 , and Seung Up Kim2,4

1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, 2Department of Internal Medicine and 3Institute of Endocrine Research, Yonsei University College of Medicine, and 4Yonsei Liver Center, Severance Hospital, Seoul, Korea

Correspondence to:Yong-ho Lee
ORCID https://orcid.org/0000-0002-6219-4942
E-mail yholee@yuhs.ac
Seung Up Kim
ORCID https://orcid.org/0000-0002-9658-8050
E-mail ksukorea@yuhs.ac

Received: June 25, 2021; Revised: September 10, 2021; Accepted: October 21, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut Liver

Published online March 24, 2022

Copyright © Gut and Liver.

Abstract

Background/Aims: Metabolic dysfunction associated fatty liver disease (MAFLD) has recently been introduced to compensate for the conventional concept of nonalcoholic fatty liver disease (NAFLD). We explored whether fibrotic burden determines the risk of atherosclerotic cardiovascular disease (ASCVD) among subjects with MAFLD.
Methods: We recruited 9,444 participants from the Korea National Health and Nutrition Examination Survey (2008 to 2011). Liver fibrosis was identified using the fibrosis-4 (FIB-4) index and NAFLD fibrosis score. The 10-year ASCVD risk score (>10%) was used to determine a high probability ASCVD risk. For sensitivity analysis, propensity score matching was assessed to subjects with aged 40 to 75 years free from ASCVD.
Results: The prevalence of MAFLD was 38.0% (n=3,592). The ASCVD risk scores stratified in quartile were positively correlated to MAFLD and FIB-4 defined-significant liver fibrosis (p for trend <0.001). Individuals with both MAFLD and FIB-4 defined-significant liver fibrosis had a greater chance of high probability ASCVD risk (odds ratio [OR]=2.40; p<0.001) than those without MAFLD. The impact of MAFLD on high probability ASCVD risk was greater than that of significant liver fibrosis (OR=4.72 for MAFLD vs OR=1.88 for FIB-4 defined-significant liver fibrosis; all p<0.001). Among participants with MAFLD, low muscle mass enhanced the risk of significant liver fibrosis (OR=1.56 to 2.43; p<0.001). When NAFLD fibrosis score was applied to define significant liver fibrosis, similar findings were observed.
Conclusions: Individuals with MAFLD had a substantial ASCVD risk compared to those without MAFLD. Accompanying significant liver fibrosis further enhanced the risk of ASCVD among subjects with MAFLD.

Keywords: Metabolic dysfunction associated fatty liver disease, Nonalcoholic fatty liver disease, Cardiovascular disease, Liver fibrosis


Article

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Gut and Liver

Published online March 24, 2022

Copyright © Gut and Liver.

Fibrotic Burden Determines Cardiovascular Risk among Subjects with Metabolic Dysfunction-Associated Fatty Liver Disease

Eugene Han1 , Yong-ho Lee2,3 , Jae Seung Lee2,4 , Hye Won Lee2,4 , Beom Kyung Kim2,4 , Jun Yong Park2,4 , Do Young Kim2,4 , Sang Hoon Ahn2,4 , Byung-Wan Lee2,3 , Eun Seok Kang2,3 , Bong-Soo Cha2,3 , and Seung Up Kim2,4

1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, 2Department of Internal Medicine and 3Institute of Endocrine Research, Yonsei University College of Medicine, and 4Yonsei Liver Center, Severance Hospital, Seoul, Korea

Correspondence to:Yong-ho Lee
ORCID https://orcid.org/0000-0002-6219-4942
E-mail yholee@yuhs.ac
Seung Up Kim
ORCID https://orcid.org/0000-0002-9658-8050
E-mail ksukorea@yuhs.ac

Received: June 25, 2021; Revised: September 10, 2021; Accepted: October 21, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: Metabolic dysfunction associated fatty liver disease (MAFLD) has recently been introduced to compensate for the conventional concept of nonalcoholic fatty liver disease (NAFLD). We explored whether fibrotic burden determines the risk of atherosclerotic cardiovascular disease (ASCVD) among subjects with MAFLD.
Methods: We recruited 9,444 participants from the Korea National Health and Nutrition Examination Survey (2008 to 2011). Liver fibrosis was identified using the fibrosis-4 (FIB-4) index and NAFLD fibrosis score. The 10-year ASCVD risk score (>10%) was used to determine a high probability ASCVD risk. For sensitivity analysis, propensity score matching was assessed to subjects with aged 40 to 75 years free from ASCVD.
Results: The prevalence of MAFLD was 38.0% (n=3,592). The ASCVD risk scores stratified in quartile were positively correlated to MAFLD and FIB-4 defined-significant liver fibrosis (p for trend <0.001). Individuals with both MAFLD and FIB-4 defined-significant liver fibrosis had a greater chance of high probability ASCVD risk (odds ratio [OR]=2.40; p<0.001) than those without MAFLD. The impact of MAFLD on high probability ASCVD risk was greater than that of significant liver fibrosis (OR=4.72 for MAFLD vs OR=1.88 for FIB-4 defined-significant liver fibrosis; all p<0.001). Among participants with MAFLD, low muscle mass enhanced the risk of significant liver fibrosis (OR=1.56 to 2.43; p<0.001). When NAFLD fibrosis score was applied to define significant liver fibrosis, similar findings were observed.
Conclusions: Individuals with MAFLD had a substantial ASCVD risk compared to those without MAFLD. Accompanying significant liver fibrosis further enhanced the risk of ASCVD among subjects with MAFLD.

Keywords: Metabolic dysfunction associated fatty liver disease, Nonalcoholic fatty liver disease, Cardiovascular disease, Liver fibrosis

Gut and Liver

Vol.16 No.3
May, 2022

pISSN 1976-2283
eISSN 2005-1212

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