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. 2022 Mar 26;11(7):1847.
doi: 10.3390/jcm11071847.

The Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Association with Physical Function and Prognosis in Patients with Acute Coronary Syndrome

Takumi Noda  1 , Kentaro Kamiya  1   2 , Nobuaki Hamazaki  3 , Kohei Nozaki  3 , Takafumi Ichikawa  3 , Masashi Yamashita  1 , Shota Uchida  1 , Emi Maekawa  4 , Tasuku Terada  5 , Jennifer L Reed  5   6   7 , Minako Yamaoka-Tojo  1   2 , Atsuhiko Matsunaga  1   2 , Junya Ako  4
Affiliations

The Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Association with Physical Function and Prognosis in Patients with Acute Coronary Syndrome

Takumi Noda et al. J Clin Med. .

Abstract

It is believed that patients with acute coronary syndrome (ACS) are at an increased risk of nonalcoholic fatty liver disease (NAFLD), which can lead to sarcopenia and physical dysfunction. However, the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and physical dysfunction and prognosis remains unclear. We investigated the prevalence of MAFLD in patients with ACS to assess the relationship between MAFLD and muscle strength, walking speed, and 6-min walking distance (6 MWD). We reviewed patients with ACS who were assessed for hepatic steatosis using the fatty liver index, and the results were further assessed to determine the presence of MAFLD. Among 479 enrolled hospitalized patients, MAFLD was identified in 234 (48.9%) patients. Multiple regression analysis revealed that MAFLD was independently associated with lower leg strength, gait speed, and 6 MWD (leg strength, p = 0.020; gait speed, p = 0.003 and 6 MWD, p = 0.011). Furthermore, in multivariate Poisson regression models after adjustment for clinical confounding factors, combined MAFLD and reduced physical functions were significantly associated with a higher incidence of clinical events. MAFLD is common in hospitalized patients with ACS and is associated with impaired physical function. Also, the coexistence of MAFLD and lower physical function predict the incidence of clinical events in patients with ACS.

Keywords: acute coronary syndrome; frailty; liver dysfunction; metabolic dysfunction-associated fatty liver disease; physical function; sarcopenia.

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Conflict of interest statement

The authors declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Prevalence of metabolic dysfunction-associated fatty liver disease according to age category.
Figure 2
Figure 2
The proportion of overlap and non-overlap among metabolic conditions in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Euler diagrams (area-proportional diagrams) visualize the number of patients in the disjoint and overlapping three metabolic disorders. Three circles indicate the prevalence of overweight or obesity, metabolic risk abnormalities, and diabetes, respectively. The percentage of the population in the single and overlapped domains is also shown. The rate is about the total cohort (n = 479).
Figure 3
Figure 3
Multiple regression models of MAFLD with leg strength, gait speed, and 6 MWD. Estimated mean values of leg strength, gait speed, and 6 MWD in multiple regression models were adjusted for age, sex, BMI, log maximum CK, number of diseased vessels, prior heart failure, hypertension, dyslipidemia, diabetes mellitus, smoking, log albumin, and log hemoglobin. MAFLD, metabolic dysfunction-associated fatty liver disease; 6 MWD, 6-min walking distance; BMI, body mass index; CK, creatine kinase.
Figure 4
Figure 4
Multiple regression models of multiple metabolic condition disorders with leg strength, gait speed, and 6 MWD. The estimated mean values of leg strength, gait speed, and 6 MWD in the multiple regression models were adjusted for age, sex, BMI, log maximum CK, number of diseased vessels, prior heart failure, hypertension, dyslipidemia, diabetes mellitus, smoking, log albumin, and log hemoglobin. MAFLD, metabolic dysfunction-associated fatty liver disease; 6 MWD, 6-min walking distance; BMI, body mass index; CK, creatine kinase.
See this image and copyright information in PMC

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