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"Ramsey Cheung"

Original Articles
Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study
Xianhua Mao, Xinrong Zhang, Rongtao Lai, Ka-Shing Cheung, Man-Fung Yuen, Ramsey Cheung, Wai-Kay Seto, Mindie H. Nguyen
Clin Mol Hepatol 2025;31(3):1084-1099.
Published online April 23, 2025
DOI: https://doi.org/10.3350/cmh.2024.1096
Background/Aims
Information about the association of glucagon-like peptide-1 receptor (GLP-1RA) with liver and non-liver complications is insufficient in patients with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD). We conducted a target trial emulation study to evaluate whether GLP-1RA decreases the risk of liver and non-liver outcomes.
Methods
Patients with T2D and MASLD initiating GLP-1RA or dipeptidyl peptidase-4 inhibitor (DPP-4i) were included from 2013 to 2022 in Merative™ Marketscan® Research Databases. Primary outcomes included incidences of (1) hepatocellular carcinoma (HCC) and cirrhosis, and (2) cardiovascular disease (CVD), chronic kidney disease (CKD), and non-liver cancer. Inverse probability of treatment weighting was applied to balance baseline characteristics and Cox regression models were conducted to estimate hazard ratio (HR) and 95% confidence interval (CI).
Results
In the intention-to-treat design, GLP-1RA, compared with DPP-4i, had a significantly lower incidence (per 1,000 person-years) of HCC (0.8 vs. 1.7; HR 0.53, 95% CI 0.39–0.71), of cirrhosis (29.3 vs. 32.9; HR 0.91, 95% CI 0.86–0.96), of CVD (57.2 vs. 73.9; HR 0.90, 95% CI 0.86–0.95), of CKD (4.5 vs. 6.8; HR 0.73, 95% CI 0.64–0.84), and of non-liver cancer (16.9 vs. 22.9; HR 0.82, 95% CI 0.77–0.89). In the per-protocol design, significant inverse associations for these study outcomes still were observed, with HR 0.60–0.77.
Conclusions
In this emulated target trial of nationwide patients with T2D and MASLD, GLP-1RA use, when compared with DPP-4i, was associated with a significantly lower risk of liver and non-liver complications.

Citations

Citations to this article as recorded by  Crossref logo
  • Evaluating causal protective effect of dual GLP-1R/GIPR agonists on MASLD: A Mendelian randomization and colocalization study
    Yangke Cai, Siyuan Xie, Liyi Xu, Jiamin Chen, Jianting Cai
    European Journal of Pharmacology.2025; 1005: 178088.     CrossRef
  • Impaired Thyroid Hormone Sensitivity is Associated with Increased Risk of Liver Fibrosis in Euthyroid Population: A Cross-Sectional Analysis of NHANES
    Xingyu Yao, Kaiwen Xiao, Hein Ko Oo
    Hormone and Metabolic Research.2025; 57(09): 511.     CrossRef
  • 11,798 View
  • 276 Download
  • 3 Web of Science
  • Crossref
Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues
Rui Huang, Dae Won Jun, Hidenori Toyoda, Yao-Chun Hsu, Huy Trinh, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Haruki Uojima, Daniel Q. Huang, Takashi Honda, Yasuhito Tanaka, Philip Vutien, Sebastián Marciano, Hiroshi Abe, Masaru Enomoto, Masanori Atsukawa, Hirokazu Takahashi, Kunihiko Tsuji, Koichi Takaguchi, Pei-Chien Tsai, Chia-Yen Dai, Jee-Fu Huang, Chung-Feng Huang, Ming-Lun Yeh, Eileen Yoon, Sung Eun Kim, Sang Bong Ahn, Gi-Ae Kim, Jang Han Jung, Soung Won Jeong, Hyunwoo Oh, Cheng-Hao Tseng, Masatoshi Ishigami, Angela Chau, Mayumi Maeda, Satoshi Yasuda, Makoto Chuma, Takanori Ito, Keigo Kawashima, Joanne Kimiko Liu, Adrian Gadano, Ritsuzo Kozuka, Norio Itokawa, Kaori Inoue, Tomonori Senoh, Jie Li, Wan-Long Chuang, Ramsey Cheung, Chao Wu, Ming-Lung Yu, Mindie H. Nguyen
Clin Mol Hepatol 2025;31(3):1003-1017.
Published online March 17, 2025
DOI: https://doi.org/10.3350/cmh.2024.1070
Background/Aims
Given the increase in prevalence of metabolic diseases, we investigated their long-term impacts on the outcomes of chronic hepatitis B (CHB) patients receiving nucleos(t)ide analogue (NA) treatment.
Methods
We analyzed data from CHB patients for whom initiated NA treatment from 30 centers. We balanced patient characteristics with and without metabolic disease (diabetes, obesity, dyslipidemia, and hypertension) via propensity-score matching (PSM) to evaluate adverse outcomes.
Results
The study included 4,500 patients. PSM yielded 909 pairs of patients with balanced characteristics. When stratified by the number of metabolic diseases, only patients with ≥2 metabolic diseases had an increased cumulative incidence of cirrhosis and overall death. However, when stratified by the presence of diabetes (regardless of the presence or number of other metabolic diseases), patients with diabetes (versus those without) had a significantly higher cumulative incidence of all outcomes: cirrhosis (P=0.009), hepatocellular carcinoma (HCC, P=0.023), and overall, liver-related, and non-liver-related death (P<0.001, P=0.026 and P<0.001, respectively). Having ≥2 metabolic diseases was associated with cirrhosis, overall death, and non-liver-related death but not HCC or liver-related death, while diabetes was significantly associated with a higher risk of all outcomes: cirrhosis (hazard ratio [HR]=3.75, P=0.004), HCC (HR=2.02, P=0.020), and overall, liver-related, and non-liver-related death (HR=2.53, P<0.001; HR=2.65, P=0.016; HR=2.38, P<0.001).
Conclusions
Having two or more metabolic diseases was associated with a higher risk of cirrhosis, overall death, and non-liver-related death, but having diabetes as a single metabolic disease was significantly associated with all adverse outcomes including cirrhosis, HCC, and overall, liver-related, and non-liver-related death.

Citations

Citations to this article as recorded by  Crossref logo
  • Advancing metabolic risk profiling in chronic hepatitis B: Reply to correspondence on “Metabolic health in antiviral era of chronic hepatitis B”
    Shang-Chin Huang, Jia-Horng Kao
    Clinical and Molecular Hepatology.2026; 32(1): e117.     CrossRef
  • Metabolic health in antiviral era of chronic hepatitis B: Editorial on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”
    Shang-Chin Huang, Jia-Horng Kao
    Clinical and Molecular Hepatology.2026; 32(1): 423.     CrossRef
  • Differential HCC risk among HBV indeterminate types at baseline and by phase transition
    Rui Huang, Huy N Trinh, Satoshi Yasuda, Angela Chau, Mayumi Maeda, Ai-Thien Do, Daniel Q Huang, Takanori Ito, Takashi Honda, Masatoshi Ishigami, Ritsuzo Kozuka, Carmen Monica Preda, Cheng-Hao Tseng, Sebastián Marciano, Pei-Chien Tsai, Dong Hyun Lee, Chris
    Gut.2025; 74(11): 1873.     CrossRef
  • Type 2 diabetes mellitus as an independent predictor of significant fibrosis in treatment-naïve chronic hepatitis B patients with concurrent hepatic steatosis
    Jie Li, Liang Xu, Fajuan Rui, Sally Tran, Pei-Chien Tsai, Youwen Tan, Hidenori Toyoda, Qing-Lei Zeng, Huy Trinh, Yao-Chun Hsu, Tsunamasa Watanabe, Hiroshi Abe, Hiroyuki Motoyama, Yoko Yoshimaru, Takanori Suzuki, Taeang Arai, Masanori Atsukawa, Phillip Vut
    Hepatology.2025;[Epub]     CrossRef
  • Incidence and determinants of achieving HBsAg <100 IU/mL in HBeAg-negative CHB patients with nucleos(t)ide analogue treatment
    Jian Wang, Tao Fan, Zhiyi Zhang, Li Zhu, Shaoqiu Zhang, Ye Xiong, Chun Shan, Chao Jiang, Shengxia Yin, Xin Tong, Renling Yao, Juan Xia, Xiaomin Yan, Yu Shi, Yuxin Chen, Xingxiang Liu, Huali Wang, Haixia Zhang, Chuanwu Zhu, Qun Zhang, Chao Wu, Rui Huang
    Emerging Microbes & Infections.2025;[Epub]     CrossRef
  • Impact of metabolic dysfunction on treatment responses to nucleos(t)ide analogues in chronic hepatitis B: a retrospective multi-center REAL-B cohort study
    Rui Huang, Dae Won Jun, Hidenori Toyoda, Yao-Chun Hsu, Huy Trinh, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Haruki Uojima, Daniel Q. Huang, Takashi Honda, Yasuhito Tanaka, Philip Vutien, Sebastián Marciano, Hiroshi Abe, Masaru Enomoto, Masanori Ats
    eClinicalMedicine.2025; 87: 103407.     CrossRef
  • Aspirin Use and Risk of HCC and Gastrointestinal Bleeding in Patients With HBV‐Related Cirrhosis: A Landmark Analysis
    Mi Na Kim, Geun U. Park, Seng Chan You, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn
    Journal of Gastroenterology and Hepatology.2025; 40(11): 2750.     CrossRef
  • Multifunctional Metal Composite Hydrogels for Diabetic Wound Therapy
    Shengnan Zhang, Hui Gao, Kevin H. Mayo, Jingang Mo, Le Deng
    Gels.2025; 11(12): 960.     CrossRef
  • 11,923 View
  • 209 Download
  • 12 Web of Science
  • Crossref

Steatotic liver disease

Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis
Nicholas A. Rouillard, Scott D. Barnett, Xinrong Zhang, Leslie Kam, Richie Manikat, Ramsey Cheung, Mindie H. Nguyen
Clin Mol Hepatol 2025;31(1):227-239.
Published online November 14, 2024
DOI: https://doi.org/10.3350/cmh.2024.0564
Background/Aims
With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery.
Methods
Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed.
Results
Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022).
Conclusions
Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Citations

Citations to this article as recorded by  Crossref logo
  • Differential Characteristics and Survival Outcomes of Patients With Cirrhosis According to Underlying Liver Aetiology
    Yu Shi, Nicholas Chien, Ashley Fong, Vy H. Nguyen, Surya Teja Gudapati, Angela Chau, Sally Tran, Linda Henry, Ramsey Cheung, Changqing Zhao, Minjuan Jin, Mindie H. Nguyen
    Alimentary Pharmacology & Therapeutics.2025; 61(10): 1622.     CrossRef
  • A leap in the dark: Bariatric surgery for treatment of metabolic dysfunction-associated steatotic liver disease related cirrhosis: Editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic live
    Jing Zeng, Jian-Gao Fan
    Clinical and Molecular Hepatology.2025; 31(2): 610.     CrossRef
  • Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Wei Wang, Yating Xie, Ailei Xu
    Clinical and Molecular Hepatology.2025; 31(2): e143.     CrossRef
  • Advancing precision medicine in metabolic dysfunction-associated steatotic liver disease
    Bryan A. Priego-Parra, Rocío Gallego-Durán, Berenice M. Román-Calleja, José Antonio Velarde-Ruiz Velasco, Manuel Romero-Gómez, Jordi Gracia-Sancho
    Trends in Endocrinology & Metabolism.2025; 36(11): 1000.     CrossRef
  • Correspondence to editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Nicholas A. Rouillard, Linda Henry, Mindie H. Nguyen
    Clinical and Molecular Hepatology.2025; 31(2): e173.     CrossRef
  • Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Jing Zeng, Jian-Gao Fan
    Clinical and Molecular Hepatology.2025; 31(2): e218.     CrossRef
  • Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Weixiong Zhu, Xuefan Zeng, Zengxi Yang, Yusheng Cheng, Wence Zhou
    Clinical and Molecular Hepatology.2025; 31(3): e252.     CrossRef
  • Association between body roundness index and risks of all-cause and cardiovascular mortality in adults with metabolic dysfunction-associated steatotic liver disease: NHANES 1999–2018
    Yanshan Yi, Li Yang
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Chi-Kuei Hsu, Po-Yu Huang, Chih-Cheng Lai
    Clinical and Molecular Hepatology.2025; 31(3): e247.     CrossRef
  • Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and a Single-Arm Meta-analysis
    Pandora Fonseca, Leonardo Pereira, João Gabriel Braga, Giovanna Macanhã Scremin, Luísa de Araujo, Julia Alves, Gabriel de França, Pedro Bregion, Rafael Rego, Maria Farias, Victor Ivano
    Obesity Surgery.2025; 35(10): 4246.     CrossRef
  • Metabolic Dysfunction Associated to Steatotic Liver Disease: A Review
    Janna Vanessa Diaz Torres, Vanessa Rocío Villanueva Guerrero, Jennifer Patricia Vargas Gómez, Fredy Javier Pacheco Miranda, Lorena Rocío Orozco Álvarez, Joseph David León Insignares, Marian Mares, Héctor Mario Rodríguez Ortiz, Evelyn Mendoza-Torres
    Metabolic Syndrome and Related Disorders.2025; 23(10): 427.     CrossRef
  • Endoscopic Bariatric Therapies for Metabolic Dysfunction-Associated Steatotic Liver Disease: Mechanistic Insights and Metabolic Implications
    Wissam Ghusn, Mira Sridharan, Rachel Fromer, Muhammet Ozdemir, Madeleine G. Haff, Eric J. Vargas
    Biomedicines.2025; 13(10): 2437.     CrossRef
  • 6,819 View
  • 179 Download
  • 10 Web of Science
  • Crossref

Steatotic liver disease

Global incidence of adverse clinical events in non-alcoholic fatty liver disease: A systematic review and meta-analysis
Michael H. Le, David M. Le, Thomas C. Baez, Hansen Dang, Vy H. Nguyen, KeeSeok Lee, Christopher D. Stave, Takanori Ito, Yuankai Wu, Yee Hui Yeo, Fanpu Ji, Ramsey Cheung, Mindie H. Nguyen
Clin Mol Hepatol 2024;30(2):235-246.
Published online January 26, 2024
DOI: https://doi.org/10.3350/cmh.2023.0485
Background/Aims
Nonalcoholic fatty liver disease (NAFLD) is associated with a multitude of adverse outcomes. We aimed to estimate the pooled incidence of NAFLD-related adverse events.
Methods
We performed a systematic review and meta-analysis of cohort studies of adults with NAFLD to evaluate the pooled incidence of adverse events.
Results
19,406 articles were screened, 409 full-text articles reviewed, and 79 eligible studies (1,377,466 persons) were included. Mean age was 51.47 years and body mass index 28.90 kg/m2. Baseline comorbidities included metabolic syndrome (41.73%), cardiovascular disease (CVD) (16.83%), cirrhosis (21.97%), and nonalcoholic steatohepatitis (NASH) (58.85%). Incidence rate per 1,000 person-years for mortality included: all-cause (14.6), CVD-related (4.53), non-liver cancer-related (4.53), and liver-related (3.10). Incidence for liver-related events included overall (24.3), fibrosis progression (49.0), cirrhosis (10.9), liver transplant (12.0), and hepatocellular carcinoma (HCC) (3.39). Incidence for non-liver events included metabolic syndrome (25.4), hypertension (25.8), dyslipidemia (26.4), diabetes (19.0), CVD (24.77), renal impairment (30.3), depression/anxiety (29.1), and non-liver cancer (10.5). Biopsy-proven NASH had higher incidence of HCC (P=0.043) compared to non-NASH. Higher rates of CVD and mortality were observed in North America and Europe, hypertension and non-liver cancer in North America, and HCC in Western Pacific/Southeast Asia (P<0.05). No significant differences were observed by sex. Time-period analyses showed decreasing rates of cardiovascular and non-liver cancer mortality and increasing rates of decompensated cirrhosis (P<0.05).
Conclusions
People with NAFLD have high incidence of liver and non-liver adverse clinical events, varying by NASH, geographic region, and time-period, but not sex.

Citations

Citations to this article as recorded by  Crossref logo
  • Polyphenols and terpenoids derived from Ocimum species as prospective hepatoprotective drug leads: a comprehensive mechanistic review
    Amrita Chatterjee, Biswatrish Sarkar
    Phytochemistry Reviews.2025; 24(2): 2087.     CrossRef
  • An updated overview on hepatocellular carcinoma in patients with Metabolic dysfunction-Associated Steatotic Liver Disease: Trends, pathophysiology and risk-based surveillance
    Angelo Armandi, Chiara Rosso, Gian Paolo Caviglia, Elisabetta Bugianesi
    Metabolism.2025; 162: 156080.     CrossRef
  • Association between skeletal muscle mass to visceral fat area ratio and depression: A cross-sectional study based on the National Health and Nutrition Examination Survey
    Chenle Ye, Guangzhan Chen, Weikai Huang, Yuanrun Liu
    Journal of Affective Disorders.2025; 372: 314.     CrossRef
  • Type 2 diabetes and the minor allele of PNPLA3 consistently identify high-risk metabolic dysfunction associated steatotic liver disease
    Zobair M. Younossi, J.Michael Estep, Sean Felix, Brian Lam, Zaid Younossi, Andrei Racila, Maria Stepanova
    Diabetes Research and Clinical Practice.2025; 219: 111960.     CrossRef
  • Correlation between metabolic dysfunction-associated steatotic liver disease and subclinical coronary atherosclerosis in eastern China
    Guanghui Ma, Guohou Xu, Haixia Huang
    Diabetology & Metabolic Syndrome.2025;[Epub]     CrossRef
  • A Novel Point-of-Care Prediction Model for Steatotic Liver Disease: Expected Role of Mass Screening in the Global Obesity Crisis
    Jeayeon Park, Goh Eun Chung, Yoosoo Chang, So Eun Kim, Won Sohn, Seungho Ryu, Yunmi Ko, Youngsu Park, Moon Haeng Hur, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Yoon Jun Kim
    Gut and Liver.2025; 19(1): 126.     CrossRef
  • Letter to the editor on “Bariatric intervention improves metabolic dysfunction-associated steatohepatitis in patients with obesity: A systematic review and meta-analysis”
    Xiao-Song Li, Xi-Ping Shen, Hang Li
    Clinical and Molecular Hepatology.2025; 31(1): e15.     CrossRef
  • PNPLA3 is one of the bridges between TM6SF2 E167K variant and MASLD: Correspondence to editorial on “TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD”
    Baokai Sun, Likun Zhuang
    Clinical and Molecular Hepatology.2025; 31(1): e67.     CrossRef
  • Metabolic dysfunction-associated steatotic liver disease and the cardiovascular system
    Antonis A. Manolis, Theodora A. Manolis, Apostolos Vouliotis, Antonis S. Manolis
    Trends in Cardiovascular Medicine.2025; 35(4): 258.     CrossRef
  • KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025
    Won Sohn, Young-Sun Lee, Soon Sun Kim, Jung Hee Kim, Young-Joo Jin, Gi-Ae Kim, Pil Soo Sung, Jeong-Ju Yoo, Young Chang, Eun Joo Lee, Hye Won Lee, Miyoung Choi, Su Jong Yu, Young Kul Jung, Byoung Kuk Jang
    Clinical and Molecular Hepatology.2025; 31(Suppl): S1.     CrossRef
  • Association Between Handgrip Strength and Cardiovascular Disease Risk in MASLD: A Prospective Study From UK Biobank
    Tae Seop Lim, Sujin Kwon, Sung A. Bae, Hye Yeon Chon, Seol A. Jang, Ja Kyung Kim, Chul Sik Kim, Seok Won Park, Kyoung Min Kim
    Journal of Cachexia, Sarcopenia and Muscle.2025;[Epub]     CrossRef
  • Underrepresentation of Asians in diagnostic test development and drug trials in MASLD
    Lung-Yi Mak, Terry Cheuk-Fung Yip, Chi-Ho Lee, Jimmy Che-To Lai, Vincent Wai-Sun Wong
    Journal of Hepatology.2025; 83(1): e59.     CrossRef
  • Mechanisms of hepatocellular carcinoma and cirrhosis development in concurrent steatotic liver disease and chronic hepatitis B
    Saisai Zhang, Lung-Yi Mak, Man-Fung Yuen, Wai-Kay Seto
    Clinical and Molecular Hepatology.2025; 31(Suppl): S182.     CrossRef
  • Reply to correspondence on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023”
    Jeayeon Park, Su Jong Yu
    Clinical and Molecular Hepatology.2025; 31(2): e221.     CrossRef
  • Comprehensive Analysis Reveals the Molecular Features and Immune Infiltration of PANoptosis-Related Genes in Metabolic Dysfunction-Associated Steatotic Liver Disease
    Yan Huang, Jingyu Qian, Zhengyun Luan, Junling Han, Limin Tang
    Biology.2025; 14(5): 518.     CrossRef
  • Association between dietary amino acid intake and the risk of metabolic dysfunction-associated steatotic liver disease
    Ruoqi Zhou, Xinrong Zhang, Xinxin Liu, Rui Huang, Yuwei Wang, Dajing Xia, Xue Li, Yihua Wu, Yu Shi
    Journal of Advanced Research.2025;[Epub]     CrossRef
  • Young Adults With Metabolic Dysfunction–Associated Steatotic Liver Disease Have an Increased Risk of Early-Onset Cancer: A Nationwide Cohort Study Differentiating the Risk of 23 Site-Specific Cancers
    Joon Ho Moon, Seogsong Jeong, Heejoon Jang, Dong Hyeon Lee, Sae Kyung Joo, Bo Kyung Koo, Qiang Xia, Meng Sha, Yoosoo Chang, Won Kim
    Clinical Gastroenterology and Hepatology.2025; 23(13): 2540.     CrossRef
  • Projected Trends in Metabolic Dysfunction–Associated Steatotic Liver Disease Mortality Through 2040
    Xinrong Zhang, Sovann Linden, Charles R. Levesley, Xinyuan He, Zhanpeng Yang, Scott D. Barnet, Ramsey Cheung, Fanpu Ji, Mindie H. Nguyen
    JAMA Network Open.2025; 8(6): e2516367.     CrossRef
  • Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association
    Kenneth Cusi, Manal F. Abdelmalek, Caroline M. Apovian, Kirthikaa Balapattabi, Raveendhara R. Bannuru, Diana Barb, Joan K. Bardsley, Elizabeth A. Beverly, Karen D. Corbin, Nuha A. ElSayed, Scott Isaacs, Fasiha Kanwal, Elizabeth J. Pekas, Caroline R. Richa
    Diabetes Care.2025; 48(7): 1057.     CrossRef
  • Validation of the FibroScan-AST (FAST) and Agile 3+ score in metabolic dysfunction-associated steatotic liver disease in a Russian cohort of patients
    V. P. Gomonova, K. L. Raikhelson, V. A. Kashchenko, A. V. Lodygin, V. E. Karev
    Meditsinskiy sovet = Medical Council.2025; (8): 134.     CrossRef
  • Chronic Kidney Disease Risk Associated With Metabolic Dysfunction‐Associated Steatotic Liver Disease: A Nationwide Cohort Study in Korea
    Dong Wook Kim, Minkook Son, Hye Jung Lee, Chi Hyeon Choi, Yeo Wool Kang, Sang Yi Moon, Myeongseok Koh, Jong Yoon Lee, Yang Hyun Baek, Won Suk An
    Hepatology Research.2025; 55(9): 1239.     CrossRef
  • All-cause and disease-specific mortality in young adults with MASLD: A nationwide cohort study
    Jeayeon Park, Goh Eun Chung, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho
    JHEP Reports.2025; 7(9): 101477.     CrossRef
  • Correlation between gynecomastia and endocrine regulation in patients with metabolic dysfunction-associated fatty liver disease: A cross-sectional study
    Ming-Huang Zhang, Ning Meng, Kang-Hui Zhang, Jun-Kang Yu, Chen-Hao Huang, Shu Yang, Ding-Yi Zhu
    World Journal of Hepatology.2025;[Epub]     CrossRef
  • Screening for MASLD in patients with type 2 diabetes: is an early diagnosis a good diagnosis?
    Chinonso Nwoguh, Christopher D Byrne, Tina Reinson, Ryan M Buchanan
    Expert Review of Gastroenterology & Hepatology.2025; 19(9): 941.     CrossRef
  • Association between metabolic dysfunction-associated steatotic liver disease and cardiovascular disease: New perspectives
    Qinyi Zhou, Wang Liu, Dan Zhou, Yifang Zhang, Zhaobing Li, Zili Li, Xiaofeng Ma
    Medicine.2025; 104(33): e43952.     CrossRef
  • Patatin-Like Phospholipase Domain-Containing Protein 3 (PNPLA3) rs738409 Variant and Non-Alcoholic Fatty Liver Disease Risk in Vietnamese Working-Age Adults: A Case-Control Study with Metabolic Insights
    Ha Nguyen, Duong Hoang Huy Le, Thinh Nguyen, Hung Cao Dinh, Tuan Nguyen
    Clinical and Experimental Gastroenterology.2025; Volume 18: 191.     CrossRef
  • Effect of hypertension on long-term adverse clinical outcomes and liver fibrosis progression in MASLD
    Xiao-Dong Zhou, Li-You Lian, Qin-Fen Chen, Seung Up Kim, Terry Cheuk-Fung Yip, Salvatore Petta, Atsushi Nakajima, Emmanuel Tsochatzis, Junping Shi, Wah-Kheong Chan, Jérôme Boursier, Elisabetta Bugianesi, Yusuf Yilmaz, Hannes Hagström, Manuel Romero-Gomez,
    Journal of Hepatology.2025;[Epub]     CrossRef
  • Acetyl-CoA Carboxylase Inhibitors for Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Nurina Hasanatuludhhiyah, Arifa Mustika, Viskasari P. Kalanjati, Muhammad Miftahussurur, Naoto Uemura
    Pharmaceuticals.2025; 18(9): 1276.     CrossRef
  • Association Between Liver Fibrosis and Cause‐Specific Mortality in Japanese Patients With Biopsy‐Confirmed Metabolic Dysfunction–Associated Steatotic Liver Disease: A Prospective Cohort Study / Liver Fibrosis and Mortality in Japanese MASLD
    Kyoko Sakai, Toshihide Shima, Hirohisa Oya, Takahiro Miura, Shohei Amioka, Takahiro Nonaka, Shinsaku Fujiishi, Keiichiro Okuda, Kei Terasaki, Kohei Fukumoto, Yasuhide Mitsumoto, Masayuki Mizuno, Takeshi Okanoue
    Hepatology Research.2025;[Epub]     CrossRef
  • The Mediating Role of Body Mass Index in the Association of Socioeconomic Status With Hepatic Steatosis and Liver Fibrosis: A Cross‐Sectional Study Based on NHANES 2021–2023
    Zongnan Chen, Xiaoling Zhu, Juan Guo, Gang Ma, Abdelilah Arredouani
    International Journal of Endocrinology.2025;[Epub]     CrossRef
  • Global burden of cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2021
    Ying Zhang, Ming Luo, Yingzi Ming
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Call to action: integrating steatotic liver disease into public health strategies in Canada
    Sahar Saeed, Jessica Burnside, Cindy Wen, Carmela Rapino, Keyur Patel, Alnoor Ramji, Mark Swain, Giada Sebastiani
    The Lancet Regional Health - Americas.2025; 52: 101278.     CrossRef
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Steatotic liver disease

Differences in liver and mortality outcomes of non-alcoholic fatty liver disease by race and ethnicity: A longitudinal real-world study
Vy H. Nguyen, Isaac Le, Audrey Ha, Richard Hieu Le, Nicholas Ajit Rouillard, Ashley Fong, Surya Gudapati, Jung Eun Park, Mayumi Maeda, Scott Barnett, Ramsey Cheung, Mindie H. Nguyen
Clin Mol Hepatol 2023;29(4):1002-1012.
Published online September 11, 2023
DOI: https://doi.org/10.3350/cmh.2023.0205
Background/Aims
Understanding of nonalcoholic fatty liver disease (NAFLD) continues to expand, but the relationship between race and ethnicity and NAFLD outside the use of cross-sectional data is lacking. Using longitudinal data, we investigated the role of race and ethnicity in adverse outcomes in NAFLD patients. Methods: Patients with NAFLD confirmed by imaging via manual chart review from any clinics at Stanford University Medical Center (1995–2021) were included. Primary study outcomes were incidence of liver events and mortality (overall and non-liver related). Results: The study included 9,340 NAFLD patients: White (44.1%), Black (2.29%), Hispanic (27.9%), and Asian (25.7%) patients. For liver events, the cumulative 5-year incidence was highest among White (19.1%) patients, lowest among Black (7.9%) patients, and similar among Asian and Hispanic patients (~15%). The 5-year and 10-year cumulative overall mortality was highest for Black patients (9.2% and 15.0%, respectively, vs. 2.5–3.5% and 4.3–7.3% in other groups) as well as for non-liver mortality. On multivariable regression analysis, compared to White patients, only Asian group was associated with lower liver-related outcomes (aHR: 0.83, P=0.027), while Black patients were at more than two times higher risk of both non-liver related (aHR: 2.35, P=0.010) and overall mortality (aHR: 2.13, P=0.022) as well as Hispanic patients (overall mortality: aHR: 1.44, P=0.022).Conclusions: Compared to White patients, Black patients with NAFLD were at the highest risk for overall and non-liver-related mortality, followed by Hispanic patients with Asian patients at the lowest risk for all adverse outcomes. Culturally sensitive and appropriate programs may be needed for more successful interventions.

Citations

Citations to this article as recorded by  Crossref logo
  • Ethnic disparities in metabolic dysfunction-associated steatotic liver disease and clinical outcomes
    Yusuke Miyatani, Aoi Ogawa, Tomoki Sempokuya, Chuong Tran, Davis James, Todd Seto, Cecilia Shikuma, Scott K. Kuwada
    Frontiers in Endocrinology.2026;[Epub]     CrossRef
  • Meta‐Analysis: Global Prevalence and Mortality of Cirrhosis in Metabolic Dysfunction‐Associated Steatotic Liver Disease
    Soroor Owrangi, James M. Paik, Pegah Golabi, Leyla de Avila, Ryuki Hashida, Ariana Nader, Annette Paik, Linda Henry, Zobair M. Younossi
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  • Statin use and liver-related prognosis among patients with MASLD
    Byungyoon Yun, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon
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  • Ethnic differences in metabolic and histologic features among White, Hispanic, Black and Asian patients with metabolic-associated Steatotic liver disease: A network meta-analysis
    Limin Lin, Jiaming Lai, Ling Luo, Junzhao Ye, Bihui Zhong
    Annals of Hepatology.2025; 30(2): 101780.     CrossRef
  • Representation of Sex, Race and Ethnicity in MASH Randomised Controlled Trials: A Systematic Review and Meta‐Analysis
    Matheus Souza, Lubna Al‐Sharif, Ivanna Diaz, Samira Mohamad Khalil, Xiu‐He Lv, Alessandro Mantovani, Cristiane Alves Villela‐Nogueira
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  • Correspondence to letter to the editor 2 on “Evolutionary changes in metabolic dysfunction-associated steatotic liver disease and risk of hepatocellular carcinoma: A nationwide cohort study”
    Seogsong Jeong, Won Kim, Sang Min Park
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    Mohamed Zaiou, Olivier Joubert
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  • Young Adults With Metabolic Dysfunction–Associated Steatotic Liver Disease Have an Increased Risk of Early-Onset Cancer: A Nationwide Cohort Study Differentiating the Risk of 23 Site-Specific Cancers
    Joon Ho Moon, Seogsong Jeong, Heejoon Jang, Dong Hyeon Lee, Sae Kyung Joo, Bo Kyung Koo, Qiang Xia, Meng Sha, Yoosoo Chang, Won Kim
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  • Projected Trends in Metabolic Dysfunction–Associated Steatotic Liver Disease Mortality Through 2040
    Xinrong Zhang, Sovann Linden, Charles R. Levesley, Xinyuan He, Zhanpeng Yang, Scott D. Barnet, Ramsey Cheung, Fanpu Ji, Mindie H. Nguyen
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  • Comparison of diagnostic criteria for fatty liver disease in assessing cardiac dysfunction: a cross-sectional study
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    Jae Hyun Bae
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  • Differences in major adverse cardiovascular events of metabolic dysfunction-associated steatotic liver disease by race and ethnicity: Letter to the editor on “Differences in liver and mortality outcomes of non-alcoholic fatty liver disease by race and eth
    Hui-Chin Chang, Wen-Chieh Liao, Yi-Jen Fang, Shiu-Jau Chen, Shuo-Yan Gau
    Clinical and Molecular Hepatology.2024; 30(4): 978.     CrossRef
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    Jae Hyun Bae
    Clinical and Molecular Hepatology.2024; 30(4): 1047.     CrossRef
  • Correspondence to editorial on “Differences in liver and mortality outcomes of non-alcoholic fatty liver disease by race and ethnicity: A longitudinal real-world study”
    Vy H. Nguyen, Mindie H. Nguyen
    Clinical and Molecular Hepatology.2024; 30(4): 1000.     CrossRef
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Viral hepatitis

Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis
Yu Jun Wong, Vy H. Nguyen, Hwai-I Yang, Jie Li, Michael Huan Le, Wan-Jung Wu, Nicole Xinrong Han, Khi Yung Fong, Elizebeth Chen, Connie Wong, Fajuan Rui, Xiaoming Xu, Qi Xue, Xin Yu Hu, Wei Qiang Leow, George Boon-Bee Goh, Ramsey Cheung, Grace Wong, Vincent Wai-Sun Wong, Ming-Whei Yu, Mindie H. Nguyen
Clin Mol Hepatol 2023;29(3):705-720.
Published online May 8, 2023
DOI: https://doi.org/10.3350/cmh.2023.0004
Background/Aims
Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients.
Methods
We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random- effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment.
Results
We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all p≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, p<0.0001).
Conclusions
IPDMA data with well-matched CHB patient groups showed that FL (vs. no FL) was associated with significantly lower HCC, cirrhosis, and mortality risk and higher HBsAg seroclearance probability.

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Forecasted 2040 global prevalence of nonalcoholic fatty liver disease using hierarchical bayesian approach
Michael H. Le, Yee Hui Yeo, Biyao Zou, Scott Barnet, Linda Henry, Ramsey Cheung, Mindie H. Nguyen
Clin Mol Hepatol 2022;28(4):841-850.
Published online September 19, 2022
DOI: https://doi.org/10.3350/cmh.2022.0239
Background/Aims
Due to increases in obesity and type 2 diabetes, the prevalence of nonalcoholic fatty liver disease (NAFLD) has also been increasing. Current forecast models may not include non-obese NAFLD. Here, we used the Bayesian approach to forecast the prevalence of NAFLD through the year 2040.
Methods
Prevalence data from 245 articles involving 2,699,627 persons were used with a hierarchical Bayesian approach to forecast the prevalence of NAFLD through 2040. Subgroup analyses were performed for age, gender, presence of metabolic syndrome, region, and smoking status. Sensitivity analysis was conducted for clinical setting and study quality.
Results
The forecasted 2040 prevalence was 55.7%, a three-fold increase since 1990 and a 43.2% increase from the 2020 prevalence of 38.9%. The estimated average yearly increase since 2020 was 2.16%. For those aged <50 years and ≥50 years, the 2040 prevalence were not significantly different (56.7% vs. 61.5%, P=0.52). There was a significant difference in 2040 prevalence by sex (males: 60% vs. 50%) but the trend was steeper for females (annual percentage change: 2.5% vs. 1.5%, P=0.025). There was no difference in trends overtime by region (P=0.48). The increase rate was significantly higher in those without metabolic syndrome (3.8% vs. 0.84%, P=0.003) and smokers (1.4% vs. 1.1%, P=0.011). There was no difference by clinical/community setting (P=0.491) or study quality (P=0.85).
Conclusion
By 2040, over half the adult population is forecasted to have NAFLD. The largest increases are expected to occur in women, smokers, and those without metabolic syndrome. Intensified efforts are needed to raise awareness of NAFLD and to determine long-term solutions addressing the driving factors of the disease.

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