New-onset age of metabolic-associated fatty liver disease and incident cardiovascular diseases: Findings from prospective cohort

<p>Whether the early-onset metabolic-associated fatty liver disease (MAFLD) would promote the development of cardiovascular disease (CVD) remains unknown. To investigate the association between MAFLD and the risks of incident CVD across different new-onset age groups, we included 67,160 participants free of MAFLD and CVD at baseline (2006-2007) from the Kailuan study. During the follow-up from baseline to December 31, 2015, 24,772 new-onset MAFLD cases were identified. Each new-onset MAFLD case was matched by one control subject randomly (age ± 1 year, sex-matched). Then 24,772 case-controls were followed up for CVD events. The end of follow-up was the first occurrence of a CVD event, the loss of the follow-up date, or the end of the follow-up (December 31, 2019). Cox proportional hazard regression models with age as the time scale were used to evaluate the hazard ratios (HRs) of incident CVD. During an average follow-up of 8.27 years, 2,881 cases of CVD were identified. After multivariate adjustment, the CVD risk gradually declined with each decade of increase in the MAFLD onset age. MAFLD cases younger than 45 years had the highest CVD risk (hazard ratio, HR, 2.64 [1.87-3.72]), while the CVD risk was attenuated in the 45 to 54 years (HR, 1.41, [1.21-1.65]). However, the HRs in two groups older than 55 years were not statistically significant (HR, 1.10 [0.96-1.25] and 1.05 [0.91-1.22]). Therefore, the onset age of MAFLD is an important predictor of CVD risk. Our finding highlights the importance of intensive prevention, screening, and management of CVD risk among individuals with early-onset MAFLD (diagnosis at <45 years).</p>