ArticleClinical and translational gastroenterology2026
Increased Cardiovascular and Cerebrovascular Events in Patients With Lean vs Non-lean MASLD: A Multicenter Analysis.
Article in Clinical and translational gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The MASLD-Cardio-Oncology Triangle: Dietary Patterns, Metabolic Remodelling and Implications for Cancer Therapy Tolerance.Nutrients · 2026Review
- Hepatic Lipoprotein Production, Cardiometabolic Phenotypes, and Subtypes of Steatotic Liver Disease.Circulation research · 2026Review
- Lean Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): Pathophysiology, Diagnostic Challenges, Clinical Outcomes, and Management.Diseases (Basel, Switzerland) · 2026Review
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionMetabolic dysfunction-associated steatotic liver disease (MASLD) represents a significant contributor to morbidity and mortality, linked to adverse cardiovascular outcomes. While extensive research highlights the cardiovascular burden in non-lean MASLD, lean MASLD remains comparatively understudied. To address this gap, our study evaluates cardiovascular outcomes in lean MASLD compared with non-lean MASLD.
methodsThis is a retrospective cohort study of patients with MASLD identified in the multi-institutional database, TriNetX. Lean MASLD was defined as a body mass index <25 kg/m 2 . Leveraging 1:1 propensity score matching, we balanced baseline characteristics, including age, sex, comorbidities, laboratory values, and medication use. Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for cardiovascular events, cerebrovascular outcomes, new-onset heart failure, and all-cause mortality over 1-, 3-, 5-, and 7-year follow-up.
resultsAfter matching, there were 67,519 patients in both groups. At 7-year follow-up, lean patients with MASLD demonstrated significantly higher rates of new onset heart failure compared with non-lean patients with MASLD (HR: 1.23, 95% CI: 1.16-1.31, P < 0.0001), composite cardiovascular events (HR: 1.21, 95% CI: 1.13-1.30, P < 0.0001), cerebrovascular events (HR: 1.33, 95% CI: 1.24-1.43, P < 0.0001), and all-cause mortality (HR: 1.48, 95% CI: 1.38-1.59, P < 0.0001). These increased risks were noted at 1-, 3-, and 5-year follow-up. DISCUSSION: Patients with lean MASLD are at significantly higher risks of cardiovascular events and all-cause mortality compared with non-lean patients with MASLD. Further research is needed to clarify the underlying pathophysiology and develop tailored interventions to improve outcomes for this growing population.
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