Sudden cardiac arrest in steatotic liver disease with metabolic dysfunc-tion or increased alcohol intake

초록

BACKGROUND The relationship between sudden cardiac arrest (SCA) and steatotic liver disease with metabolic dysfunction or alcohol intake remains poorly defined. OBJECTIVE We aimed to evaluate the characteristics of metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD) and their associations with SCA. METHODS We analyzed a random 40% sample of South Korean adults who underwent a national health screening in 2012. Steatotic liver disease was defined by a fatty liver index of >= 60 and classified as MASLD, MetALD, orALD based on metabolic criteria and alcohol consumption. The primary outcome was SCA identified using diagnostic claim codes through December 2022. RESULTS Among 4,420,306 individuals (mean age 48.1 years; 46.1% female), MASLD, MetALD, and ALD were identified in 451,990 (10.2%), 81,289 (1.8%), and 40,067 participants (0.9%), respectively. SCA occurred in 20,150 individuals (0.5%). Individuals categorized as ALD conferred the highest adjusted risk of SCA (hazard ratio [HR] 2.07; 95% confidence interval [CI] 1.86-2.30), followed by MASLD (HR 1.87; 95% CI 1.77-1.97) and MetALD (HR 1.60; 95% CI 1.45-1.77; all P < .001). The association between MetALD and SCA was stronger in adults younger than 40 years. CONCLUSION MASLD, MetALD, and ALD were each associated with higher SCA risk, with risk rising markedly in ALD. Met-ALD did not exceed MASLD in overall SCA risk, but demonstrated a disproportionate impact in younger adults.

키워드