Link between liver fibrosis in MASLD, ASCVD varies by glycemic status

01 Aug 2026, 01:00 · Medical Xpress

by Elana Gotkine

edited by Sadie Harley, reviewed by Alexander Pol

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For patients with metabolic dysfunction-associated steatotic liver disease (MASLD), the association between liver fibrosis and atherosclerotic cardiovascular disease (ASCVD) varies with glycemic status, according to a study published in Hepatology Communications.

Jaehong Jeong, M.D., from Yonsei University College of Medicine in Seoul, South Korea, and colleagues conducted a retrospective cohort study of individuals with MASLD to examine whether fibrosis severity assessed using guideline-recommended noninvasive liver fibrosis pathways is associated with incident ASCVD across glycemic states.

Data were included for 6,519 individuals with MASLD who had both fibrosis-4 and vibration-controlled transient elastography data; 3,243 had normoglycemia, 2,369 had prediabetes and 907 had diabetes. The survival analysis cohort included 3,221 participants.

The researchers observed an increase in baseline 10-year ASCVD risk with worsening glycemic status. The association between fibrosis severity and incident ASCVD differed by glycemic status in the longitudinal analysis. For patients with prediabetes, incident ASCVD risk was higher in association with the highest fibrosis tier (adjusted subdistribution hazard ratio, 2.62).

In younger individuals, this association was more apparent. Five-year cumulative ASCVD incidence was higher across fibrosis tiers in individuals with diabetes (15.2% to 18.5%), with no significant increase by fibrosis severity.

"These findings support a tailored approach to ASCVD risk assessment in MASLD," the authors write. "Fibrosis severity assessed during MASLD evaluation may provide additional clinical information, particularly in patients with prediabetes or younger individuals."

More information

Jaehong Jeong et al, The risk of cardiovascular events in metabolic dysfunction–associated steatotic liver disease according to fibrosis stage and diabetes status: A cohort study, Hepatology Communications (2026). DOI: 10.1097/hc9.0000000000001013

Key medical concepts

Liver FibrosisFibrosis-4 Score

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GastroenterologyCardiologyEndocrinology Who's behind this story?

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