A recent review published in Current Cardiology Reports highlighted the increased risk of cardiovascular complications in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH). These patients require at least one other cardiometabolic risk factor for a diagnosis of MASLD, and the pro-atherogenic milieu generated in these conditions closely overlaps with the pathophysiology of cardiovascular disease. This overlap has led to greater incidences of cardiovascular disease in MASLD patients.
The review emphasized the importance of regular cardiovascular risk assessments in this patient population and the value of both pharmacological and lifestyle interventions. Clinical interventions primarily focus on managing cardiovascular risk factors, with a particular emphasis on diet, exercise, and weight loss. Research suggests that exercise can positively influence the prevention and resolution of fatty liver disease, and sufficient weight loss has been shown to improve markers of liver damage in MASLD patients.
Statin therapy is recommended as the first-line treatment, with treatment intensity correlating with individual cardiovascular risk and degree of liver damage. However, statin interventions are underutilized in cases of MASLD accompanied by dyslipidemia. The review also discussed potential alternate interventions such as bariatric surgery, peroxisome proliferator-activated receptor agonists, sodium/glucose contransporter-2 inhibitors, and GLP-1 receptor agonists for patients with MASLD/MASH.
In conclusion, the review pointed to the potential benefits of these alternate interventions for MASLD/MASH patients and the need for further research to explore their impact on cardiovascular risk reduction. The authors highlighted the importance of addressing cardiovascular risk factors in this patient population to improve long-term outcomes and quality of life.
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