The correlation between liver fibrosis and the 10-year estimated risk of cardiovascular disease in adults with metabolic-associated fatty liver disease: A cross-sectional study in Vietnam.

ABSTRACT

Background and Aims: Metabolic-associated fatty liver disease (MAFLD) emerged as a novel term replacing nonalcoholic fatty liver disease (NAFLD) in 2020. While most MAFLD patients are asymptomatic, long-term hepatic fat accumulation may lead to liver fibrosis and cardiovascular disease (CVD). Nevertheless, the relationship between MAFLD and cardiovascular (CV) risk factors remains unclear. This study aimed to assess the 10-year estimated CVD risk in individuals diagnosed with MAFLD. Methods: Between January 2022 and August 2023, this cross-sectional study enrolled 139 MAFLD patients. We employed the systematic coronary risk evaluation 2 (SCORE2) and the systematic coronary risk evaluation 2-older persons (SCORE2-OP) scoring systems to evaluate and categorize the 10-year CV risk. Liver fibrosis was assessed using biochemical parameters (FIB-4, AST/ALT, and APRI), and their correlation with CV risk was examined. Results: Most MAFLD patients were categorized as having high or very high CV risk based on the SCORE2 and SCORE2-OP. Liver fibrosis, measured by the FIB-4 score, significantly differed among the various CV risk groups. Moreover, FIB-4 correlated positively with SCORE2 and SCORE2-OP (r = 0.588, p < 0.001), indicating its substantial predictive ability for identifying individuals at very high CV risk (AUC = 0.765, 95% CI 0.686-0.845, p < 0.001). A FIB-4 score of 1.275 demonstrated 81% sensitivity and 64% specificity in predicting very high CV risk among MAFLD patients. Conclusion: Patients with MAFLD predominantly face high or very high CV risks, with elevated liver fibrosis associated with increased 10-year estimated CVD risk. The FIB-4 score exhibits promising predictive value for identifying MAFLD patients at very high risk of CV disease.