Clinical Outcomes of Acute Pancreatitis in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD): A Systematic Review and Meta-Analysis.

BACKGROUND

Metabolic dysfunction-associated fatty liver disease (MAFLD) is being increasingly identified in patients with acute pancreatitis (AP). However, their prognostic significance remains debatable.

OBJECTIVE

We conducted a systematic review and meta-analysis to examine the association between MAFLD and the clinical outcomes of AP.

METHODS

Comprehensive searches were conducted in the PubMed, Embase, Web of Science, Cochrane Library, Scopus, and Ovid databases up to June 2, 2025. This analysis included observational studies that compared acute pancreatitis (AP) outcomes in patients with and without metabolic-associated fatty liver disease (MAFLD). Pooled odds ratios (ORs), mean differences (MDs), and 95% confidence intervals (CIs) were calculated using fixed or random-effects models depending on the heterogeneity observed. Subgroup and sensitivity analyses were also performed.

RESULTS

A total of ten studies involving 6,436 patients were analyzed. Patients with metabolic-associated fatty liver disease (MAFLD) had a significantly higher risk of severe acute pancreatitis (Odds Ratio [OR] = 1.86), organ failure (OR = 1.65), and in-hospital mortality (OR = 1.71) than those without MAFLD. Additionally, MAFLD was linked to greater local complications and more extended hospital stay. Sensitivity and subgroup analyses confirmed the reliability of these findings.

CONCLUSION

Metabolic-associated fatty liver disease (MAFLD) is associated with poor clinical outcomes in patients with acute pancreatitis (AP), including increased severity, complications, and mortality rates. These findings indicate that MAFLD should be incorporated into the clinical risk stratification and management strategies for AP.