Comparative effects of non-alcoholic fatty liver disease and metabolic dysfunction-associated fatty liver disease on risk of incident cardiovascular events: a meta-analysis of about 13 million individuals

We performed a meta-analysis of observational cohort studies (by searching PubMed, Scopus and Web of Science from database inception to 30 June 2022) that simultaneously used the NAFLD and MAFLD definitions for examining the risk of incident CVD events associated with both definitions, among adults with and without either NAFLD or MAFLD, and in which hepatic steatosis was diagnosed by imaging techniques or blood biomarkers/scores. Studies using liver biopsy were not available. The primary outcomes were CVD mortality, non-fatal CVD events or both. Data from selected studies were extracted, and meta-analysis was performed using random-effects models to obtain summary HRs with 95% CIs. In the case of studies reporting HRs with varying degrees of covariate adjustment, those reflecting the maximum extent of adjustment for confounding factors were extracted. The study was registered on Open Science Framework (number: osf.io/gtvqm). Online supplemental table 1 and online supplemental figure 1 summarise the syntax used as well as the results of search and selection processes.