Nutrition journal · 2026
Association between high-risk metabolic dysfunction-associated steatohepatitis and ischemic heart disease: a nationally representative study.
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Yuan Bin, Zheng Xuehong, Wu Zhimeng, Zhu Lihan, Fang Changchang, Xu Yi, Xu Jihao, Zhao Huilei, Wang Jingfeng, Yu Peng, Liu Xiao, Chen Zhiqiang
Аннотация
BACKGROUND: The relationship between metabolic dysfunction-associated steatohepatitis (MASH) and ischemic heart disease (IHD) remains incompletely understood. This study investigated this association in the U.S. adults utilizing the FibroScan-AST (FAST) score, a validated non-invasive tool for identifying high-risk MASH.
METHODS: This cross-sectional study included 3,696 adults in the 2017-2018 National Health and Nutrition Examination Survey. We defined high-risk MASH as FAST score ≥ 0.35. We performed logistic regression to investigate the association between high-risk MASH and prevalent IHD. FAST was calculated by liver stiffness measurement (LSM), controlled attenuation parameter (CAP), and aspartate aminotransferase (AST).
RESULTS: The prevalence of IHD was significantly higher in the high-risk MASH group than in the non-high-risk group (10.5% vs. 5.8%). Both LSM (adjusted odds ratio (aOR) 1.84, 95% CI 1.28-2.65) and CAP (aOR 3.06, 95% CI 1.32-7.12) were independently associated with IHD after adjustment, whereas AST did not demonstrate a significant association (aOR 0.83, 95% CI 0.48-1.43). High-risk MASH was independently associated with IHD (aOR: 2.08; 95% CI: 1.18-3.65). Subgroup analysis suggested a potential sex-specific interaction (P for interaction = 0.035), with a pronounced association in males (aOR: 2.51; 95% CI: 1.32-4.75) but was not statistically significant in females (aOR: 0.36, 95% CI 0.07-1.27).
CONCLUSION: High-risk MASH defined by the FAST score is independently associated with prevalent IHD in the U.S.
POPULATION: Future prospective cohort studies are warranted to validate whether intervation of high-risk MASH improves cardiovascular outcomes.
METHODS: This cross-sectional study included 3,696 adults in the 2017-2018 National Health and Nutrition Examination Survey. We defined high-risk MASH as FAST score ≥ 0.35. We performed logistic regression to investigate the association between high-risk MASH and prevalent IHD. FAST was calculated by liver stiffness measurement (LSM), controlled attenuation parameter (CAP), and aspartate aminotransferase (AST).
RESULTS: The prevalence of IHD was significantly higher in the high-risk MASH group than in the non-high-risk group (10.5% vs. 5.8%). Both LSM (adjusted odds ratio (aOR) 1.84, 95% CI 1.28-2.65) and CAP (aOR 3.06, 95% CI 1.32-7.12) were independently associated with IHD after adjustment, whereas AST did not demonstrate a significant association (aOR 0.83, 95% CI 0.48-1.43). High-risk MASH was independently associated with IHD (aOR: 2.08; 95% CI: 1.18-3.65). Subgroup analysis suggested a potential sex-specific interaction (P for interaction = 0.035), with a pronounced association in males (aOR: 2.51; 95% CI: 1.32-4.75) but was not statistically significant in females (aOR: 0.36, 95% CI 0.07-1.27).
CONCLUSION: High-risk MASH defined by the FAST score is independently associated with prevalent IHD in the U.S.
POPULATION: Future prospective cohort studies are warranted to validate whether intervation of high-risk MASH improves cardiovascular outcomes.