Metabolic dysfunction-associated fatty liver disease does not increase mortality in adults

The presence of the novel metabolic dysfunction-associated fatty liver disease (MAFLD) is not associated with higher mortality in a cohort of individuals aged 45–80 years, reveals a study.

This single-centre cohort study assessed the relevance of MAFLD for mortality. Using the colorectal cancer screening programme, the authors identified 4,718 individuals aged 45–80 years who were grouped according to their body mass index (BMI) and the presence or absence of MAFLD.

Mortality was compared between the two groups through a systematic read-out of the national health insurance system. Fatty liver (FL) was diagnosed via ultrasound.

FL had an overall prevalence of 47.9 percent: 1,200 (25.4 percent) patients were lean (BMI <25 kg/m²) and did not have MAFLD, 73 (1.5 percent) were lean and had nonalcoholic FL disease but did not fulfill the criteria for MAFLD, and 221 (4.7 percent) were lean and fulfilled the criteria for MAFLD.

In addition, 1,043 (22.1 percent) and 925 (19.6 percent) participants had MAFLD with overweight (BMI 25–30 kg/m²) and obesity (BMI ≥30 kg/m²), respectively, while 1,041 (22.1 percent) and 215 (4.6 percent) were overweight and obese, respectively, without FL.

A total of 278 deaths (5.9 percent) occurred during a median follow-up of 7.5 years (interquartile range, 4.0–9.6), of which 98 (2.1 percent) were cancer-related, 65 (1.4 percent) were cardiovascular, and 17 (0.4 percent were liver-related).

Overall survival was comparable between groups (after 5 years: 93.9 percent to 98.2 percent), with lean MAFLD correlating with numerically worst survival.

“Although lean and overweight patients with MAFLD had a numerically worse outcome compared to their non-MAFLD counterparts, this association was driven by age and metabolic comorbidities (predominantly diabetes) rather than the presence of MAFLD,” the authors noted.