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Article Abstract
Aim: In patients with metabolic dysfunction-associated steatotic liver disease (MASLD), the prognosis and outcomes, particularly non-liver-related mortality, remain insufficiently elucidated. We investigated all-cause mortality in patients with MASLD to elucidate the association of the severity of liver fibrosis with liver-related and non-liver-related mortality in MASLD.
Methods: Among 4528 participants with MASLD, we examined the causes of death and analyzed liver-related and non-liver-related mortality, stratified by the degree of fibrosis using the competing risk method. Fibrosis severity was assessed using the Fibrosis-4 (FIB-4) and FIB-3 indices.
Results: The median follow-up period was 11.7 years. Of the 4528 participants, 551 died during the follow-up period, with only 37 (6.7%) deaths attributable to liver-related diseases and 514 (93.3%) to non-liver-related causes. For the risk of hepatocellular carcinoma, the hazard ratios (HRs; 95% confidence interval [CI]) for FIB-4 were 5.67 (2.20-14.59) and 32.14 (12.40-83.35) and for FIB-3 were 5.43 (2.73-10.79) and 19.96 (10.50-37.93). For liver-related mortality, the HRs (95% CI) for FIB-4 were 6.32 (2.23-17.85) and 27.62 (9.74-78.37) and for FIB-3 were 7.15 (2.62-19.50) and 19.86 (8.12-48.55), respectively. In contrast, intermediate and high FIB-4 and FIB-3 indices were unassociated with non-liver-related mortality: HRs (95% CI) for FIB-4 were 0.85 (0.70-1.04) and 0.87 (0.64-1.18), and for FIB-3 were 0.96 (0.77-1.20) and 0.92 (95% CI, 0.64-1.31), respectively.
Conclusions: The progression of liver fibrosis was unassociated with mortality from non-liver-related causes in patients with MASLD.
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| http://dx.doi.org/10.1111/hepr.14164 | DOI Listing |
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