Extrahepatic Comorbidities Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease; A Tertiary Hospital Experience

Abstract

Background

Fatty liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD) have recently been recognized as a major global health issue, and there is much evidence linking MASLD with a range of extrahepatic comorbidities. The current study evaluated extrahepatic comorbidities in patients with MASLD and highlighted the necessity of a multidisciplinary approach to its management.

Methods

A cross-sectional study was conducted at a tertiary center in Tehran. Fatty liver  was diagnosed via ultrasonography findings. Exclusion criteria included those with other liver diseases, such as chronic viral hepatitis. Participants underwent liver stiffness measurement using Fibroscan, and clinical data and liver function tests were collected, and questionnaires for DASS-21 and the Pittsburg Sleep Quality Index (PSQI) were completed. We conducted a Chi-square test and ANOVA test to evaluate and explore the extrahepatic comorbidities and manifestations associated with fatty liver disease.

Results

Of the 385 study participants, 50.6% had severe steatosis, and 29.1% had severe fibrosis. Several comorbidities, such as hypertension (fibrosis: P=0.033, steatosis: P=0.011), diabetes (fibrosis: P=0.006, steatosis: P=0.002), and poor sleep quality (fibrosis: P=0.015), were significantly associated with the severity of NAFLD. There were statistically significant differences in mean scores of depression and anxiety across different levels of fibrosis and steatosis (P<0.05).

Conclusion

MASLD is a multisystem disorder with widespread extrahepatic manifestations impacting many organs and systems. Patients with MASLD should be screened for comorbidities such as diabetes, cardiovascular disease, and mental health conditions to improve overall health outcomes and prevent disease advancement.