Estimated pulse wave velocity in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality

Donghee Kim; Richie Manikat; Karn Wijarnpreecha; George Cholankeril; Aijaz Ahmed

doi:10.1111/jgh.16608

Estimated pulse wave velocity in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality

J Gastroenterol Hepatol. 2024 May 13. doi: 10.1111/jgh.16608. Online ahead of print.

Authors

Donghee Kim¹, Richie Manikat¹, Karn Wijarnpreecha^{2

3}, George Cholankeril^{4

5}, Aijaz Ahmed¹

Affiliations

¹ Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
² Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, Arizona, USA.
³ Department of Internal Medicine, Division of Gastroenterology and Hepatology, Banner University Medical Center, Phoenix, Arizona, USA.
⁴ Liver Center, Division of Abdominal Transplantation, Michael E DeBakey Department of General Surgery, Baylor College of Medicine, Houston, Texas, USA.
⁵ Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

PMID: 38740513
DOI: 10.1111/jgh.16608

Abstract

Background and aim: Several reports show a significant association between metabolic dysfunction-associated steatotic liver disease (MASLD) and arterial stiffness (estimated pulse wave velocity [ePWV]) as a surrogate marker of vascular age. We investigate whether ePWV as arterial stiffness in MASLD is associated with all-cause/cause-specific mortality.

Methods: This cohort study was based on the third National Health and Nutrition Examination Survey (NHANES, 1988-1994) and NHANES 2007-2014 and linked mortality datasets through 2019. Cox regression models assessed the association between ePWV categorized by quartile and all-cause/cause-specific mortality among individuals with MASLD.

Results: During the follow-up of a median of 26.3 years (interquartile range: 19.9-27.9), higher levels of ePWV among individuals with MASLD were associated with increased all-cause mortality, which remained significant after adjusting for demographic, lifestyle, clinical, and metabolic risk factors. Furthermore, higher ePWV in MASLD was associated with higher cardiovascular mortality. There was a 44% (hazard ratio: 1.44, 95% confidence interval: 1.32-1.58) increase in all-cause mortality and a 53% (hazard ratio: 1.53, 95% confidence interval: 1.32-1.77) increase in cardiovascular mortality for every 1 m/s increase in ePWV in MASLD. However, there was no significant association between ePWV and cancer-related mortality. Sensitivity analyses using the NHANES 2007-2014 dataset showed results identical to the original analysis.

Conclusion: Higher ePWV in MASLD was associated with a higher risk of all-cause and cardiovascular mortality beyond traditional cardiovascular risk factors. Screening for ePWV in individuals with MASLD may be an effective and beneficial approach to reducing all-cause and cardiovascular mortality.

Keywords: MASLD; arterial stiffness; death; steatotic liver disease; vascular age.