Cardiometabolic criteria as predictors and treatment targets of liver‐related events and cardiovascular events in metabolic dysfunction‐associated steatotic liver disease

Summary Background The diagnosis of metabolic dysfunction‐associated steatotic liver disease (MASLD) requires at least one of five cardiometabolic criteria. It is unclear whether these criteria can be used as predictors and treatment targets for complications including liver‐related events and major adverse cardiovascular events (MACE). Aims To investigate the relationship between cardiometabolic criteria and complications. Methods We conducted a nationwide, population‐based study of 979,352 patients with MASLD. We investigated relationships between a number of criteria at baseline and liver‐related events or MACE risks. In a separate longitudinal analysis, we included patients with five criteria at baseline and investigated the relationship between improving the criteria and the incidence of complications after 1 year. Results The cumulative incidence of MACE, but not liver‐related events, increased with increasing baseline cardiometabolic criteria. In the longitudinal study, multivariable analysis using patients with five criteria (no improvement) as the reference, adjusted hazard ratios (95% confidence interval) of MACE in patients with 4, 3, 2, and 0–1 criteria (1 to 4–5 criteria improvement) were 0.55 (0.52–0.58, p