Sudden cardiac arrest in steatotic liver disease with metabolic dysfunction 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, or ALD 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. MetALD did not exceed MASLD in overall SCA risk, but demonstrated a disproportionate impact in younger adults.

키워드