The new steatotic liver disease nomenclature identifies different risk trajectories for liver-related complications in compensated patients - 08/11/26
, Hassane Njimi 1, 2 , Jackie Bitton 1 , Lauren-Ange Djia Meyapyali 3 , Delphine Degré 1, 4 , Antonia Lepida 1 , Laura Weichselbaum 1 , Nathalie Boon 1 , Eric Trépo 1, 4 , Lukas Otero-Sanchez 1, 4 , Thierry Gustot 1, 4 , Christophe Moreno 1, 4, ⁎ Highlights |
• | Natural history differences across MASLD, MetALD, ALD remain poorly studied. |
• | Alcohol intake and fibrosis stage are the main drivers of liver-related events. |
• | ALD shows highest risk of events, MASLD the lowest. |
• | Diabetes independently increases risk of liver-related events. |
Abstract |
Background & Aims |
Recently, a new nomenclature for steatotic liver disease (SLD) defines metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD), and alcohol-related liver disease (ALD), according to alcohol consumption and presence of metabolic risk factors. This study aimed to identify risk factors associated with liver-related events (LREs) in patients with SLD.
Methods |
A single-center study including 335 patients with biopsy-proven SLD was conducted between 2009 and 2021. Patients with other causes of chronic liver disease or prior decompensated liver disease were excluded. The incidence of LREs and associated risk factors were analyzed using a Fine and Gray competing risk model, with non-liver-related death as a competing event.
Results |
A total of 335 patients were included with a median follow-up of 3.6 years. Among them, 221 were classified as MASLD, 26 as MetALD, and 88 as ALD. Advanced fibrosis (F3–F4) was observed in 55% of MASLD, 50% of MetALD, and 68% of ALD patients. During follow-up, LREs occurred in 9% of MASLD patients, 19% of MetALD patients, and 30% of ALD patients. Overall mortality was 12% in MASLD, 19% in MetALD, and 21% in ALD. In multivariable analysis, advanced fibrosis, daily alcohol intake, and diabetes were independently associated with LREs.
Conclusions |
Across the SLD spectrum, alcohol consumption and fibrosis stage are major risk factors for liver-related events. Accurate assessment of alcohol intake, although challenging in clinical practice, remains essential to optimize patient care.
Le texte complet de cet article est disponible en PDF.Keywords : steatotic liver disease, liver-related events, alcohol, diabetes
Plan
| Financial support statement: no financial support was received for this study |
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| Clinical trial number: NA |
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