An international multidisciplinary consensus statement on MAFLD and the risk of CVD

Xiao Dong Zhou, Giovanni Targher, Christopher D. Byrne, Virend Somers, Seung Up Kim, C. Anwar A. Chahal, Vincent Wai Sun Wong, Jingjing Cai, Michael D. Shapiro, Mohammed Eslam, Philippe Gabriel Steg, Ki Chul Sung, Anoop Misra, Jian Jun Li, Carlos Brotons, Yuli Huang, George V. Papatheodoridis, Aijun Sun, Yusuf Yilmaz, Wah Kheong ChanHui Huang, Nahum Méndez-Sánchez, Saleh A. Alqahtani, Helena Cortez-Pinto, Gregory Y.H. Lip, Robert J. de Knegt, Ponsiano Ocama, Manuel Romero-Gomez, Marat Fudim, Giada Sebastiani, Jang Won Son, John D. Ryan, Ignatios Ikonomidis, Sombat Treeprasertsuk, Daniele Pastori, Monica Lupsor-Platon, Herbert Tilg, Hasmik Ghazinyan, Jerome Boursier, Masahide Hamaguchi, Mindie H. Nguyen, Jian Gao Fan, George Boon Bee Goh, Mamun Al Mahtab, Saeed Hamid, Nilanka Perera, Jacob George*, Ming Hua Zheng*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

38 Citations (Scopus)


Background: Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25–30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. Methods and results: A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. Conculsions: The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

Original languageEnglish
Pages (from-to)773-791
Number of pages19
JournalHepatology International
Issue number4
Early online date19 May 2023
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
The authors thank two Delphi study methodologists Prof. Joey S.W. Kwong (St. Luke's International University, Japan) and Prof. Zubing Mei (Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China) for methodological assistance. Seung Up Kim, Vincent Wai-Sun Wong, Mohammed Eslam, Yusuf Yilmaz, Wah Kheong Chan, Sombat Treeprasertsuk, Hasmik Ghazinyan, Jian-Gao Fan, George Boon-Bee Goh, Saeed Hamid, Jacob George and Ming-Hua Zheng are members of the APASL MAIDEN.

Publisher Copyright:
© 2023, Asian Pacific Association for the Study of the Liver.


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