MAFLD Predicts the Risk of Cardiovascular Disease Better than NAFLD in Asymptomatic Subjects with Health Check-Ups

Hyoeun Kim, Chan Joo Lee, Sang Hoon Ahn, Kwan Sik Lee, Byoung Kwon Lee, Su Jung Baik, Seung Up Kim, Jung Il Lee

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Background and Aim: Metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to compensate for the conventional concept of nonalcoholic fatty liver disease (NAFLD). We investigated the superiority of MAFLD versus NAFLD in predicting the risk of atherosclerotic cardiovascular disease (ASCVD). Methods: A total of 2,144 subjects without a history of ASCVD, who underwent a comprehensive medical health check-up, were selected for the study. The associations between fatty liver status and coronary risk surrogates, such as coronary artery calcium score (CACS), coronary artery disease, quantitative stenosis grade, and 10-year ASCVD risk, were analyzed. Results: MAFLD and NAFLD were identified in 995 (46.4%) and 891 (41.6%) subjects, respectively. Subjects with MAFLD or NAFLD were more likely to be male and had a significantly higher prevalence of central obesity, obesity, hypertension, diabetes, and dyslipidemia (all, p < 0.05) than their counterparts. In terms of coronary risk surrogates, the MAFLD or NAFLD population had a significantly higher proportion of subjects with CACS > 100, coronary artery disease, higher grade of coronary artery stenosis, and higher 10-year ASCVD risk (all, p < 0.05) than their counterparts. Multivariable logistic regression models showed an independent association between MAFLD/NAFLD and coronary risk surrogates (all, p < 0.05). However, NAFLD only, defined as ‘NAFLD, but not MAFLD,’ was not associated with an increased coronary risk, compared to MAFLD. Conclusions: Although both MAFLD and NAFLD discriminated different ASCVD risks, MAFLD predicted the risk of ASCVD better than NAFLD in asymptomatic subjects who underwent medical health check-ups.

Original languageEnglish
Pages (from-to)4919-4928
Number of pages10
JournalDigestive diseases and sciences
Issue number10
Publication statusPublished - 2022 Oct

Bibliographical note

Funding Information:
This study was supported by the Technology Innovation Program (20013712) funded by the Ministry of Trade, Industry and Energy (MOTIE, Korea) and by Basic Science Research Program through the NRF of Korea funded by the Ministry of Education (NRF-2017R1D1A1B03034053). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding Information:
Chan Joo Lee has received lecture honoraria from Novartis, Hanmi Pharmaceutical, Yuhan, Boryung Pharmaceutical, and Daiichi Sankyo. He has also received a research grant from Boryung Pharmaceutical; Seung Up Kim has served as an advisory committee member Gilead Sciences, GSK, Bayer, and Eisai. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, Abbive, EchoSens, MSD, and Bristol-Myers Squibb. He has also received a research grant from Abbive and Bristol-Myers Squibb. The other authors declare that they have no competing interests.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology


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