Mortality outcomes in individuals with MASLD versus MASLD and increased alcohol intake
Open accessAbstract
Background and Aim: Metabolic dysfunction‐associated steatotic liver disease (MASLD) has become a leading cause of chronic liver disease worldwide. A new entity termed MetALD has also been described and is defined as individuals with MASLD and increased alcohol intake. However, the natural history of MetALD compared with MASLD is unknown. We aimed to compare longitudinal outcomes in patients with MASLD versus MetALD. Methods: This study was performed using data from the National Health and Nutrition Examination Survey from 2011 to 2018. MASLD patients (defined by the United States Fatty Liver Index > 30) who met cardiometabolic criteria including body mass index (BMI) > 25 (BMI > 23 in Asians), hypertension, diabetes mellitus, dyslipidemia, and hypertriglyceridemia were included. MetALD was defined as MASLD with increased alcohol intake (3–6 standard drinks per day in males; 2–5 standard drinks per day in females). A comparison of overall, cardiovascular, cancer‐related, and other causes of mortality in patients with MASLD versus MetALD was performed. Results: A total of 2838 individuals with MASLD and 2557 individuals with MetALD were included with a median follow‐up time of 56 months. MetALD patients were at increased risk of cancer‐related mortality compared with patients with MASLD (hazard ratio 1.32; 95% confidence interval 1.14–1.53; P < 0.01). However, there was no significant difference in overall, cardiovascular, and other causes of mortality. Conclusions: Patients with MetALD were at higher risk for cancer‐related mortality than MASLD. Close attention to regular cancer surveillance and accurate classification of alcohol consumption in individuals with diagnosed MASLD is warranted to help improve patient care and outcome.
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- Authors
- Aboona, M. B., Danpanichkul, P., Chen, V. L., Rangan, P., Kim, D., Alkhouri, N., Fallon, M. B., Noureddin, M., Arab, J. P., & Wijarnpreecha, K.
- Affiliations
- University of Arizona College of Medicine- Phoenix (US)
- Texas Tech University (US)
- Michigan Medicine (US)
- Stanford Medicine (US)
- Liver Institute Northwest (US)
- Banner - University Medical Center Phoenix (US)
- Houston Methodist (US)
- Pontificia Universidad Católica de Chile (CL)
- Corresponding author
- Aboona, Majd B.
- Wijarnpreecha, Karn
- ORCID
- Venue
- Journal of Gastroenterology and Hepatology
- Publisher
- Wiley
- Published
- 2024-08-22
- Volume
- 39
- Issue
- 11
- Pages
- 2456-2463
- ISSN
- 0815-9319 (ISSN-L)
- 1440-1746
- PMC
- PMC11620910
- OpenAlex
- W4401826572
- Cited by
- 29
- References
- 47
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 6
- FWCI
- 8.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Gastroenterology and Hepatology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K08 DK132312)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, MetALD, alcohol consumption, mortality, cancer mortality, cardiovascular mortality, all-cause mortality, cardiometabolic risk, cancer surveillance
- MeSH terms
- Adult, Aged, Alcohol Drinking, Cardiovascular Diseases, Fatty Liver, Female, Humans, Male, Middle Aged, Neoplasms, Nutrition Surveys, United States
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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