Association between metabolic dysfunction-associated steatotic liver disease and atherosclerotic cardiovascular disease in a tertiary care hospital: A cross-sectional study
Reem K. AlManea, Kossay El-Abd, Sara H. Alsinan, Alanoud Alrakban, Dana AlTannir, Dana DaherAbstract:
BACKGROUND:
Obesity, diabetes, and metabolic syndrome are becoming increasingly prevalent in Saudi Arabia, and therefore, raising concerns about metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic steatohepatitis (MASH), and related cardiovascular complications. This study compared the occurrence of atherosclerotic cardiovascular disease (ASCVD) and calculated risk scores in patients with MASLD or MASH versus those with no imaging evidence of hepatic steatosis (“Healthy Liver” group).
MATERIALS AND METHODS:
We retrospectively reviewed medical records of adults aged ≥18 years who had undergone abdominal imaging, including ultrasound, computed tomography, or magnetic resonance imaging between 2018 and 2022 at a tertiary care hospital in Riyadh. Data extracted included demographic characteristics, medical history, laboratory results, and results of imagaing reports. Data was analyzed using Stata; Fisher's exact test was used to test for association between liver health status and ASCVD events whereas t-test compared ASCVD risk scores between groups.
RESULTS:
The study included 532 patients with a mean age of 53.5 years, most of whom were women (64.3%), Saudi nationals (78.0%), and overweight or obese (50.4%). Common comorbidities found in them included dyslipidemia (42.9%), hypertension (35.2%), diabetes (34.2%), and hypothyroidism (21.4%). Frequently prescribed medications were statins (39.5%), antihypertensive agents (36.1%), and antidiabetic therapies (38.9%). All 14 documented ASCVD events occurred in patients with MASLD or MASH, while no events were observed in individuals with healthy livers (
CONCLUSION:
The ASCVD events were observed exclusively in MASLD/MASH patients, suggesting a potential association. Given the small event burden and retrospective design, findings are exploratory. Locally relevant Saudi data highlight the need for larger prospective studies to validate cardiovascular implications of fatty liver disease.