Cited by 29Liver Disease Diagnosis and TreatmentAlcohol Consumption and Health EffectsLiver Diseases and Immunity

Mortality outcomes in individuals with MASLD versus MASLD and increased alcohol intake

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Aboona, Majd B., Danpanichkul, Pojsakorn, Chen, Vincent L, Rangan, Pooja, Kim, Donghee, Alkhouri, Naim, Fallon, Michael B., Noureddin, Mazen +2 more·2024·Journal of Gastroenterology and Hepatology

Abstract

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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  1. [27]Kanwal F, Neuschwander-Tetri BA, Loomba R, Rinella ME. Metabolic dysfunction-associated steatotic liver disease: update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease. Hepatology 2024; 79: 1212– 9. 38445559 PMC13435502

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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
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
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
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

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