Evidence map›Paper›PMID 40576655›Full record

ArticleHepatology communications2025

Prevalence and outcomes of steatotic liver disease subtypes in older adults.

Daniel Clayton-Chubb, Ammar Majeed, Isabella Commins, Robyn L Woods, Andrew T Chan, Joanne Ryan, Johannes T Neumann, Hans G Schneider, Andrew M Tonkin, Mark R Nelson and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. The dynamic spectrum of steatotic liver disease: the global perspective.Nature reviews. Gastroenterology & hepatology · 2026
    Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Daniel Clayton-ChubbDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.ORCID 0000-0001-7479-9669
Ammar MajeedDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.
Isabella ComminsDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.
Robyn L WoodsSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Andrew T ChanClinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
Joanne RyanSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Johannes T NeumannDepartment of Cardiology, University Heart and Vascular Center (UHZ), Hamburg, Germany.
Hans G SchneiderSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Andrew M TonkinSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Mark R NelsonSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Sharyn M FitzgeraldSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Suzanne G OrchardSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
John S LubelDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.
Daniel R SikaviClinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
Cammie TranSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Alexander D HodgeDepartment of Gastroenterology, Eastern Health, Melbourne, Australia.
John J McNeilSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
William W KempDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.
Stuart K RobertsDepartment of Gastroenterology, Alfred Health, Melbourne, Australia.ORCID 0000-0002-9015-7997

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MURRAY, ANNE M · 2019 to 2023
$42.9M
NIA NIH HHS U01 AG029824NIA NIH HHS U19 AG062682
6 · The paper itself

Abstract

backgroundSteatotic liver disease (SLD) is a significant cause of chronic liver disease. However, the relative prevalence and prognostic significance of various disease entities according to recently defined classification systems (MAFLD vs. the SLD-spectrum of MASLD, Met-ALD, and ALD) is understudied in older adults.

methodsPost hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) study involving 16,703 Australian community-dwelling adults aged ≥70 years free from significant disability, prior cardiovascular disease events, and with a life expectancy ≥5 years. Steatosis was identified by Fatty Liver Index (FLI) ≥60. Alcohol intake was self-reported. SLD subtypes were classified according to European Association for the Study of the Liver (EASL)/American Association for the Study of Liver Diseases (AASLD) guidelines. Cox regression was used to estimate hazard ratios for adjudicated outcomes: mortality, major adverse cardiovascular events (MACE), and persistent physical disability.

resultsOf 9847 participants with calculable FLI and a median 8.6 years follow-up, 3748 (38.1%) had hepatic steatosis. Substratifying by MAFLD criteria versus the SLD type, 3743 had MAFLD (38.0%), and 3464 (35.2%) met SLD criteria (MASLD 3132 [90.4%], Met-ALD 262 [7.6%], ALD 74 [2.0%]) (excluding steatogenic medication users). There was no increased mortality risk with MAFLD or SLD. MAFLD and MASLD were associated with MACE when adjusted for age and sex (HR 1.42 [95% CI 1.17-1.71] and HR 1.40 [95% CI 1.15-1.71], respectively), but not in the fully adjusted model. MAFLD, MASLD, and ALD were associated with an increased risk of persistent physical disability even when fully adjusted (HR 1.46 [95% CI 1.19-1.79], HR 1.49 [95% CI 1.20-1.83], HR 2.53 [95% CI 1.27-5.05], respectively), but not Met-ALD.

conclusionsMAFLD and the metabolic-SLD spectrum are common in community-dwelling older adults. No subclassification is associated with increased mortality in this group, although there is an association between both MACE and persistent physical disability with SLD.

Indexed as

Fatty LiverNon-alcoholic Fatty Liver DiseaseAgedAged, 80 and overAustraliaCardiovascular DiseasesFemaleHumansMalePrevalencePrognosisalcoholbiochemistryepidemiologyliver functionmetabolic syndromeolder adults

Identifiers

PMID40576655
PMCPMC12208646

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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 OpenQuestion graph.