Abstract Body (Do not enter title and authors here): Background: MASLD is a liver disease defined by fat accumulation not caused by alcohol. It is closely associated with metabolic conditions like diabetes and obesity. In the U.S., it is the most common chronic liver disease, with CVD as the leading cause of death in affected individuals.
Objective: To Identify and compare biomarkers in individuals with MASLD alone versus those with MASLD and CVD. Using NHANES and National Death Index (NDI) data, to improve prediction of CVD progression among MASLD patients.
Methods: NHANES (1999–2018) and NDI data were merged to evaluate biomarkers in individuals with MASLD alone and with CVD. Multicollinearity was assessed using VIF, and linear regression to identify significant biomarkers, adjusting for age, sex, and race.
Results: From 1999 to 2018, 217,458,895 individuals were evaluated. Of these, 192,069,036 tested negative, and 25,389,859 tested positive for MASLD. Among the MASLD-positive group, 2,229,096 also had CVD. Of those with steatosis alone, 1,628,303 died from steatosis-related causes; 577,896 with both steatosis and CVD died from CVD-related causes.Patients with hepatic steatosis showed increased odds of developing CVD with elevated gamma-glutamyl transferase (GGT) (OR: 1.005, p < 0.002, CI: 1.002–1.008), increasing age (OR: 1.061, p < 0.000, CI: 1.044–1.078), and glycohemoglobin (OR: 1.275, p < 0.042, CI: 1.011–1.609). Among those with both steatosis and CVD who died, risk factors included decreased albumin (OR: 0.079, p < 0.028, CI: 0.011–0.581), older age (OR: 1.068, p < 0.025, CI: 1.016–1.124), non-Hispanic white race (OR: 4.445, p < 0.041, CI: 1.241–15.924), and elevated total protein (OR: 1.068, p < 0.023, CI: 2.058–177.795). Patients with steatosis alone who died had decreased albumin (OR: 0.400, p < 0.038, CI: 0.170–0.943), elevated AST (OR: 0.952, p < 0.036, CI: 0.909–0.996), increased GGT (OR: 1.008, p < 0.006, CI: 1.002–1.014), and elevated total protein (OR: 2.458, p < 0.003, CI: 1.039–1.133).
Conclusion: Distinct biomarkers are associated with MASLD and MASLD complicated by CVD, highlighting the need for further studies to understand CVD progression in MASLD patients.