SynthesisPloS one2025
Comparative association between NAFLD and MAFLD with cardiovascular events and mortality: Evidence from observational studies.
Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Patients with MASH experience worse health-related quality of life: a multinational real-world study using LiverMultiScan.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Trial
- From Molecular Mechanisms to Clinical Strategies: A Comprehensive Overview of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).International journal of molecular sciences · 2026Review
- Gut Microbiota and Metabolic Dysfunction-Associated Steatotic Liver Disease: From Dysbiosis to Metagenomic Insights and Therapeutic Perspectives.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Development and external validation of an interpretable machine learning model for diagnosing coronary heart disease in patients with type 2 diabetes and MASLD.Frontiers in endocrinology · 2026Article
- Repurposing levothyroxine for managing metabolic dysfunction-associated steatotic liver disease.Endocrine · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are increasingly recognized as multisystemic conditions with significant extrahepatic manifestations. Although both diseases have been linked to cardiovascular events and mortality, the strength of these associations remains controversial. This review aims to compare the risks of cardiovascular disease (CVD) events in individuals with NAFLD and MAFLD.
methodsThe PubMed, Embase, and Cochrane Library databases were searched to identify studies investigating the risk of CVD, CVD death, and all-cause death associated with NAFLD and MAFLD through April 28th, 2024. Data extraction and study quality assessment were performed using the Newcastle-Ottawa Scale. Statistical analysis utilized random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.
resultsEleven cohort studies with 11,995,994 patients were included. Both NAFLD and MAFLD were associated with an increased risk of cardiovascular events (NAFLD group vs. non-NAFLD group: HR = 1.30, 95% confidence interval (CI): 1.13-1.49, I2 = 91%; MAFLD group vs. non-MAFLD group: HR = 1.54, 95% CI: 1.32-1.81, I2 = 92%) and all-cause death (NAFLD group vs. non-NAFLD group: HR = 1.18, 95% CI: 1.04-1.33, I2 = 55%; MAFLD group vs. non-MAFLD group: HR = 1.30, 95% CI: 1.20-1.40, I2 = 0%). The MAFLD-only group had a stronger association with cardiovascular death than the NAFLD-only group (MAFLD-only group vs neither MAFLD nor NAFLD group: HR = 1.46, 95% CI: 1.40-1.51, I2 = 0%; NAFLD-only group vs neither MAFLD nor NAFLD group: HR = 1.10, 95% CI: 0.95-1.28, I2 = 0%, P for interaction < 0.01). The GRADE assessment revealed low certainty for cardiovascular disease (CVD) (NAFLD only group vs. neither NAFLD nor MAFLD group), cardiovascular death (NAFLD only group vs. neither NAFLD nor MAFLD group), and all-cause death (MAFLD group vs non-MAFLD group), and very low certainty for other results.
conclusionMAFLD and NAFLD are both associated with cardiovascular events and all-cause mortality. However, the odds of cardiovascular death seems to be greater in patients with MAFLD than in those with NAFLD, suggesting that the use of MAFLD criteria may identify more at-risk individuals. PROSPERO REGISTRATION: CD42022361164.
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