Evidence mapPaperPMID 42520169Full record

ArticleHepatology communications2026

The risk of cardiovascular events in metabolic dysfunction-associated steatotic liver disease according to fibrosis stage and diabetes status: A cohort study.

Jaehong Jeong, Jung Pyo Hong, Dong Yun Kim, Jae Seung Lee, Mi Na Kim, Jeong Eun Song, Hyun Chin Cho, Beom Kyung Kim, Jun Yong Park, Do Young Kim and 3 more

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Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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13 authors.

Jaehong JeongDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0009-0004-0628-2587
Jung Pyo HongDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0009-0004-5768-1342
Dong Yun KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-2471-3385
Jae Seung LeeDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-2371-0967
Mi Na KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0001-5381-230
Jeong Eun SongDepartment of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea.ORCID 0000-0002-1034-4478
Hyun Chin ChoDepartment of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.ORCID 0000-0001-7750-474
Beom Kyung KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-5363-2496
Jun Yong ParkDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0001-6324-2224
Do Young KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-8327-3439
Sang Hoon AhnDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-3629-4624
Hye Won LeeDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-3552-3560
Seung Up KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-9658-8050

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality in metabolic dysfunction-associated steatotic liver disease (MASLD). We investigated whether fibrosis severity assessed using guideline-recommended noninvasive liver fibrosis pathways was associated with incident ASCVD across different glycemic states.

methodsThis retrospective cohort study included subjects with MASLD. Fibrosis severity was classified using the Korean Association for the Study of the Liver/European Association for the Study of the Liver (KASL/EASL) and American Gastroenterological Association (AGA) sequential pathways, based on fibrosis-4 followed by vibration-controlled transient elastography. Incident ASCVD was analyzed using Fine-Gray subdistribution hazard models, with death treated as a competing event.

resultsAmong 6519 subjects with MASLD who had both fibrosis-4 and vibration-controlled transient elastography data, 3243 had normoglycemia, 2369 had prediabetes, and 907 had diabetes; 3221 were included in the survival analysis cohort. Baseline 10-year ASCVD risk increased with worsening glycemic status. In the longitudinal analysis, the association between fibrosis severity and incident ASCVD differed by glycemic status. In patients with prediabetes, the highest fibrosis tier was associated with higher incident ASCVD risk (adjusted subdistribution hazard ratio: 2.62, p=0.024). This association was also more apparent in younger individuals. In patients with diabetes, 5-year cumulative ASCVD incidence was high across fibrosis tiers (15.2%-18.5%), without a significant increase by fibrosis severity.

conclusionsHigher liver fibrosis severity assessed by noninvasive tests was associated with incident ASCVD outcomes in selected MASLD subgroups, particularly patients with prediabetes and younger individuals. Fibrosis assessment may help identify patients who warrant closer cardiometabolic evaluation when interpreted alongside established ASCVD risk prediction tools.

Indexed as

AtherosclerosisCardiovascular DiseasesDiabetes MellitusLiver CirrhosisNon-alcoholic Fatty Liver DiseaseAdultAgedCohort StudiesElasticity Imaging TechniquesFemaleHumansIncidenceMaleMiddle AgedRepublic of KoreaRetrospective Studiesatherosclerotic cardiovascular diseasediabetes mellitusfibrosis-4 indexliver fibrosismetabolic dysfunction–associated steatotic liver diseasevibration-controlled transient elastography

Identifiers

PMID42520169
PMCPMC13412647

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.