1278-P: Changes in Cardiovascular Disease (CVD) Incidence Due to Remission of Diabetes and Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD)

The leading cause of death in patients with steatotic liver disease (SLD) is CVD. As SLD is frequently associated with metabolic disorders such as type 2 diabetes (DM), the concept of MASLD has been proposed. MASLD can be classified according to the type of associated metabolic dysfunction. Among MASLD subtypes, MASLD with DM (DM-MASLD) was shown to have a major impact on the development of CVD. However, the presence of SLD and status of concomitant metabolic abnormalities change over time. Since it is unclear how the incidence of CVD changes when DM-MASLD transitions, this study aimed to clarify this issue. Included were 11592 participants selected from a nationwide claims database from 2008 to 2019 who underwent health screening 2 years before baseline (B-2) and who had DM-MASLD at B-2 but without CVD at baseline. Participants were classified by whether DM and MASLD remained or were in remission, respectively, from B-2 to baseline. Incidence of new onset of CVD in each category was analyzed by a multivariate Cox proportional hazard model. During a median follow up of 4.9 y, 446 CVD events occurred. Changes in incidence of CVD due to changes in DM and MASLD status are shown in Figure 1. Remission in DM and MASLD each significantly reduced the incidence of CVD. Remission of hepatic steatosis in DM-MASLD patients was comparable to remission of DM in preventing new onset of CVD.