Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Sex-Specific Impact of Metabolic Dysfunction-Associated Fatty Liver Disease on Incident Cardiovascular Diseases and Mortality Publisher Pubmed



Abbaszadeh M1 ; Hosseinpanah F2 ; Tohidi M3 ; Karimpour Reyhan S1 ; Mahdavi M2 ; Valizadeh M2
Authors
Show Affiliations
Authors Affiliations
  1. 1. Endocrinology and Metabolism Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
  3. 3. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Endocrinology, Diabetes and Metabolism Published:2025


Abstract

Background and Aims: Considering recent revisions in the nomenclature for fatty liver disease, alongside limited data on sex-specific differences in its cardiovascular/mortality outcomes, this study aims to investigate the prevalence and impact of metabolic-associated fatty liver disease (MAFLD) on cardiovascular disease (CVD) and mortality in men and women over a 12-year follow-up period. Methods: In this large population-based cohort study, 7101 individuals aged ≥ 30 were enrolled. The prevalence of MAFLD was investigated in both genders. After excluding individuals with a history of previous CVD, 6331 participants were followed up for CVD and mortality over 12 years. Steatosis was defined as fatty liver index (FLI) ≥ 60. Multivariate-adjusted hazard ratios (HRs) were calculated for CVD and mortality. Results: The prevalence of MAFLD was 43.2%, higher in men (46.5%) than women (40.6%). Men with MAFLD (47.7 ± 12.1) were younger than women (52.2 ± 11.1). In the 12-year follow-up of 6331 individuals, multivariable-adjusted CVD HRs for MAFLD were 1.36 (1.10–1.67) in men and 1.48 (1.16–1.88) in women. Adjusted mortality HRs were 1.17 (0.86–1.59) and 1.38 (1.00–1.91) in men and women, respectively. Among patients with MAFLD, a subgroup with diabetes faced the highest hazard for CVD and mortality. Conclusion: This study found that MAFLD is more common in men at a younger age. Despite the higher prevalence in men, women with MAFLD face a greater risk of cardiovascular events and mortality. Findings highlight the importance of gender-specific considerations in primary prevention programmes for MAFLD-related cardiovascular disease and mortality. © 2025 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
Related Docs
View other Related Docs
1. Associations Between Dairy Products Consumption and Risk of Type 2 Diabetes: Tehran Lipid and Glucose Study, International Journal of Food Sciences and Nutrition (2015)
2. Blood Pressure and Cardiovascular Morbidity Risk in Type 2 Diabetes With Hypertension Over a Decade of Follow-Up: Evidence for J-Shaped Phenomenon, Journal of Human Hypertension (2017)
3. Direct and Indirect Effects of Central and General Adiposity on Cardiovascular Diseases: The Tehran Lipid and Glucose Study, European Journal of Preventive Cardiology (2018)
4. Socio-Behavioral Factors Associated With Overweight and Central Obesity in Tehranian Adults: A Structural Equation Model, International Journal of Behavioral Medicine (2017)
5. Prevalence of Impaired Renal Function and Determinants in the Southwest of Iran, BMC Nephrology (2021)
6. Factors Associated With Pre-Diabetes in Tehranian Men and Women: A Structural Equations Modeling, PLoS ONE (2017)
7. Abdominal Obesity Phenotypes and Incident Diabetes Over 12 Years of Follow-Up: The Tehran Lipid and Glucose Study, Diabetes Research and Clinical Practice (2018)
8. Sex Specific Impact of Different Obesity Phenotypes on the Risk of Incident Hypertension: Tehran Lipid and Glucose Study, Nutrition and Metabolism (2019)
Experts (# of related papers)
View all Related Experts
Mohammad Ali Mansournia (11)
Samaneh Akbarpour (5)
Other Related Docs
9. A New Approach to Test Validity and Clinical Usefulness of the 2013 Acc/Aha Guideline on Statin Therapy: A Population-Based Study, International Journal of Cardiology (2015)
10. The Pathophysiological Associations Between Obesity, Nafld, and Atherosclerotic Cardiovascular Diseases, Hormone and Metabolic Research (2024)
11. Sex-Specific Incidence Rates and Risk Factors for Fracture: A 16-Year Follow-Up From the Tehran Lipid and Glucose Study, Bone (2021)
12. The Risk and Added Values of the Atherosclerotic Cardiovascular Risk Enhancers on Prediction of Cardiovascular Events: Tehran Lipid and Glucose Study, Journal of Translational Medicine (2021)
13. Fibrosis Score 4 Index Has an Independent Relationship With Coronary Artery Diseases in Patients With Metabolic-Associated Fatty Liver Disease, Diabetology and Metabolic Syndrome (2023)
14. Dietary Consumption of Advanced Glycation End Products and Risk of Metabolic Syndrome, International Journal of Food Sciences and Nutrition (2016)
15. High Dietary and Lifestyle Inflammatory Scores Are Associated With Increased Risk of Chronic Kidney Disease in Iranian Adults, Nutrition Journal (2023)
16. Contribution of Obesity and Cardiometabolic Risk Factors in Developing Cardiovascular Disease: A Population-Based Cohort Study, Scientific Reports (2022)
17. Weight Loss Breaks the Bond Between Nonalcoholic Fatty Liver Disease and Cardiovascular Diseases: A Clinical and Epidemiological Perspective, Obesity Reviews (2023)
18. The Association Between Index-Year, Average, and Variability of the Triglyceride-Glucose Index With Health Outcomes: More Than a Decade of Follow-Up in Tehran Lipid and Glucose Study, Cardiovascular Diabetology (2024)
19. Incidence of Thyroid Dysfunction Facing Metabolic Syndrome: A Prospective Comparative Study With 9 Years of Follow-Up, European Thyroid Journal (2021)
20. The Higher Adherence to Healthy Lifestyle Factors Is Associated With a Decreased Risk of Metabolic Syndrome in Iranian Adults, Nutrition Bulletin (2022)
21. Risk of Coronary Heart Events Based on Rose Angina Questionnaire and Ecg Besides Diabetes and Other Metabolic Risk Factors: Results of a 10-Year Follow-Up in Tehran Lipid and Glucose Study, International Journal of Endocrinology and Metabolism (2017)
22. Predictive Value of Women’S Weight Trajectories in Determining Familial Cardiovascular Disorders: A Family-Based Longitudinal Study, Scientific Reports (2021)
23. Diabetes, Hypertension, and Incidence of Chronic Kidney Disease: Is There Any Multiplicative or Additive Interaction?, International Journal of Endocrinology and Metabolism (2021)
24. Dietary Patterns and Risk of Chronic Kidney Disease Among Tehranian Adults With High Blood Pressure, International Journal of Endocrinology and Metabolism (2020)
25. Diabetes Mellitus Risk Prediction in the Presence of Class Imbalance Using Flexible Machine Learning Methods, BMC Medical Informatics and Decision Making (2022)
26. Factors Affecting Gender Differences in the Association Between Health-Related Quality of Life and Metabolic Syndrome Components: Tehran Lipid and Glucose Study, PLoS ONE (2015)
27. Mean Versus Variability of Lipid Measurements Over 6 Years and Incident Cardiovascular Events: More Than a Decade Follow-Up, Frontiers in Cardiovascular Medicine (2022)
28. Do Trends of Adiposity and Metabolic Parameters Vary in Women With Different Ovarian Reserve Status? a Population-Based Cohort Study, Menopause (2020)
29. Association Between Metabolic Score for Insulin Resistance and Clinical Outcomes: Insights From the Tehran Lipid and Glucose Study, Nutrition and Metabolism (2024)
30. Animal Based Low Carbohydrate Diet Is Associated With Increased Risk of Type 2 Diabetes in Tehranian Adults, Diabetology and Metabolic Syndrome (2020)
31. Effect of Aging, Menopause, and Age at Natural Menopause on the Trend in Body Mass Index: A 15-Year Population-Based Cohort, Fertility and Sterility (2019)
32. The Higher Adherence to a Healthy Lifestyle Score Is Associated With a Decreased Risk of Type 2 Diabetes in Iranian Adults, BMC Endocrine Disorders (2022)
33. Dyslipidemia Incidence and the Trend of Lipid Parameters Changes in Women With History of Gestational Diabetes: A 15-Year Follow-Up Study, Endocrine (2017)
34. The Association of Dietary and Lifestyle Indices for Insulin Resistance With the Risk of Cardiometabolic Diseases Among Iranian Adults, Scientific Reports (2023)
35. Trend of Various Adiposity Indices in Women With and Without History of Gestational Diabetes: A Population-Based Cohort Study, BMC Endocrine Disorders (2019)
36. Causes and Predictors of Premature Death in the Pars Cohort Study, Iran: A Cohort Study, BMC Public Health (2024)
37. Polypill Protects Mafld Patients From Cardiovascular Events and Mortality: A Prospective Trial, Hepatology International (2023)
38. White Rice Intake and Incidence of Type-2 Diabetes: Analysis of Two Prospective Cohort Studies From Iran, BMC Public Health (2017)
39. Sugar-Sweetened Beverages and Risk of Obesity and Its Related Cardiovascular Risk Factors in Iranian Adults, Iranian Journal of Endocrinology and Metabolism (2015)
40. Ldl-Cholesterol Measurement in Diabetic Type 2 Patients: A Comparison Between Direct Assay and Popular Equations, Journal of Diabetes and Metabolic Disorders (2017)
41. Dietary Intakes of Flavonoids and Carotenoids and the Risk of Developing an Unhealthy Metabolic Phenotype, Food and Function (2020)
42. Distribution of Body Mass Index in Children With Different Parental Risk: Findings of a Family-Based Cohort Study in a West-Asian Population, Scientific Reports (2019)
43. Optimizing Cardiovascular Disease Mortality Prediction: A Super Learner Approach in the Tehran Lipid and Glucose Study, BMC Medical Informatics and Decision Making (2024)
44. Effects of a Healthy Lifestyle Education on the Incidence of Metabolic Syndrome in Children During a 13-Year Follow-Up, International Journal of Behavioral Medicine (2018)
45. Diabetes in Women and Health-Related Quality of Life in the Whole Family: A Structural Equation Modeling, Health and Quality of Life Outcomes (2019)
46. Subnational Exposure to Secondhand Smoke in Iran From 1990 to 2013: A Systematic Review, Environmental Science and Pollution Research (2021)
47. Changes Over-Time in Blood Pressure of Women With Preeclampsia Compared to Those With Normotensive Pregnancies: A 15 Year Population-Based Cohort Study, Pregnancy Hypertension (2019)
48. Serum Alkaline Phosphatase and the Risk of Coronary Heart Disease, Stroke and All-Cause Mortality: Tehran Lipid and Glucose Study, BMJ Open (2018)
49. Sex-Specific Clinical Outcomes of Impaired Glucose Status: A Long Follow-Up From the Tehran Lipid and Glucose Study, European Journal of Preventive Cardiology (2019)
50. Predictors of Early Adulthood Hypertension During Adolescence: A Population-Based Cohort Study, BMC Public Health (2017)