Abstract
BACKGROUND: Metabolic-dysfunction associated steatotic liver disease (MASLD) is associated with prevalent cardiovascular disease. More favorable cardiovascular health (CVH) profiles are associated with a lower prevalence of MASLD in crosssectional studies. The relationship between long-term CVH patterns and MASLD prevalence in midlife remains unknown. METHODS AND RESULTS: Participants (aged 18–30 years at baseline) of the CARDIA (Coronary Artery Risk Development in Young Adults) study who had individual CVH components measured at 7 examinations over 20 years and liver fat assessed by noncontrast computed tomography at year 25 follow-up were included. CVH score was defined using published American Heart Association definitions. Group-based trajectory modeling was used to identify CVH trajectories. MASLD was defined as liver attenuation of ≤51 Hounsfield units with at least 1 metabolic risk factor after excluding other causes of liver fat. Logistic regression was used to examine associations of CVH trajectory groups and MASLD prevalence. At baseline, 39% of 2529 participants had high and 5% had low CVH, respectively. MASLD prevalence at year 25 was 23% (n=587). Five distinct CVH trajectories were identified. Between the 2 groups that started at similar CVH scores, those whose CVH declined over time had a higher prevalence of MASLD at year 25 (7.0% in high-stable versus 23.0% high-decreasing; 24.4% in moderate-stable versus 35.7% in moderate-decreasing). Lower and decreasing trajectories were associated with higher year-25 MASLD prevalence compared with the high-stable trajectory. CONCLUSIONS: Achieving and maintaining high CVH scores starting in young adulthood lowers the risk of prevalent MASLD in midlife.
| Original language | English (US) |
|---|---|
| Article number | e037948 |
| Journal | Journal of the American Heart Association |
| Volume | 14 |
| Issue number | 8 |
| DOIs | |
| State | Published - Apr 15 2025 |
Funding
This article has been reviewed by CARDIA for scientific content. Author contributions: The authors confirm contribution to the article as follows: study conception and design: S.W.P., L.B.V.W, H.N., M.R.C.; analysis and interpretation of results: S.W.P., H.N., L.B.V.W., M.R.C.; draft article preparation: S.W.P., L.B.V.W., M.R.C.; oversight of the study: L.B.V.W., M.R.C. All authors reviewed the results and approved the final version of the article. The CARDIA study is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (75N92023D00002 and 75N92023D00005), Northwestern University (75N92023D00004), University of Minnesota (75N92023D00006), and Kaiser Foundation Research Institute (75N92023D00003). L.B.V.W. received support from the National Clinical and Translational Sciences Institute (KL2TR001424). L.B.V.W. consults for Madrigal Pharmaceuticals, Gerson Lehrman Group, Slingshot Insights and Alpha Sights, receives research support from W.L. Gore & Associates and Madrigal Pharmaceuticals, and provides medicolegal services outside of the submitted work. The remaining authors have no disclosures to report.
Keywords
- Life’s Simple 7
- NAFLD
- cardiovascular health
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
