INFLAMMATORY AND METABOLIC BURDEN OF MASLD AND ALCOHOL-OVERLAP STEATOTIC LIVER DISEASE IN SOUTH KOREA
Author(s)
Minseol Jang, PharmD1, Miryoung Kim, PhD2, Hae Sun Suh, MA, MS, PhD3.
1PhD Student, Kyung Hee University, Seoul, Korea, Republic of, 2Sunchon National University, Suncheon-si, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
1PhD Student, Kyung Hee University, Seoul, Korea, Republic of, 2Sunchon National University, Suncheon-si, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been associated with chronic systemic inflammation and metabolic dysfunction, but whether these associations according to cardiometabolic risk burden remains unclear. We aimed to compare clinical characteristics, inflammatory and metabolic burden of MASLD in a nationally representative Korean population.
METHODS: We utilized data from the Korea National Health and Nutrition Examination Survey of 2018-2024. MASLD was defined as a hepatic steatosis index of at least 36, in the presence of at least one cardiometabolic risk factor. High-sensitivity C-reactive protein (hs-CRP) and uric acid were evaluated as markers of inflammatory and metabolic burden, respectively. Cardiometabolic risk-factor burden was quantified as the number of cardiometabolic risk factors present. Ordinary least-squares models evaluated the associations of MASLD with hs-CRP and uric acid after adjustment for age, sex, survey year, cardiometabolic risk-factor count, and MASLD-by-risk-factor-count interaction.
RESULTS: Among 36,106 eligible adults, 10,590 (29.3%) were classified as MASLD. Participants with MASLD had less favorable anthropometric, glycemic, lipid, inflammatory, and liver enzyme profiles than those without MASLD. In adjusted models, MASLD remained independently associated with higher hs-CRP (β=0.40; p<0.001) and uric acid (β=0.38; p<0.001). Each additional cardiometabolic risk factor was associated with higher hs-CRP (β=0.10, p<0.001) and uric acid (β=0.17, p<0.001). Significant MASLD-by-risk-factor interactions were observed for hs-CRP (β=-0.13, p=0.003) and uric acid (β=-0.13, p<0.001), indicating that the incremental associations of MASLD with both biomarkers diminished as cardiometabolic risk-factor burden increased. This pattern was primarily driven by glucose abnormalities and hypertension, whereas adiposity strengthened the association between MASLD and uric acid.
CONCLUSIONS: MASLD was independently associated with greater inflammatory and metabolic burden beyond conventional cardiometabolic risk factors. The strongest associations were observed among individuals with relatively low cardiometabolic risk-factor burden, suggesting that MASLD may serve as an early indicator of inflammatory and metabolic dysfunction before the accumulation of multiple cardiometabolic abnormalities.
METHODS: We utilized data from the Korea National Health and Nutrition Examination Survey of 2018-2024. MASLD was defined as a hepatic steatosis index of at least 36, in the presence of at least one cardiometabolic risk factor. High-sensitivity C-reactive protein (hs-CRP) and uric acid were evaluated as markers of inflammatory and metabolic burden, respectively. Cardiometabolic risk-factor burden was quantified as the number of cardiometabolic risk factors present. Ordinary least-squares models evaluated the associations of MASLD with hs-CRP and uric acid after adjustment for age, sex, survey year, cardiometabolic risk-factor count, and MASLD-by-risk-factor-count interaction.
RESULTS: Among 36,106 eligible adults, 10,590 (29.3%) were classified as MASLD. Participants with MASLD had less favorable anthropometric, glycemic, lipid, inflammatory, and liver enzyme profiles than those without MASLD. In adjusted models, MASLD remained independently associated with higher hs-CRP (β=0.40; p<0.001) and uric acid (β=0.38; p<0.001). Each additional cardiometabolic risk factor was associated with higher hs-CRP (β=0.10, p<0.001) and uric acid (β=0.17, p<0.001). Significant MASLD-by-risk-factor interactions were observed for hs-CRP (β=-0.13, p=0.003) and uric acid (β=-0.13, p<0.001), indicating that the incremental associations of MASLD with both biomarkers diminished as cardiometabolic risk-factor burden increased. This pattern was primarily driven by glucose abnormalities and hypertension, whereas adiposity strengthened the association between MASLD and uric acid.
CONCLUSIONS: MASLD was independently associated with greater inflammatory and metabolic burden beyond conventional cardiometabolic risk factors. The strongest associations were observed among individuals with relatively low cardiometabolic risk-factor burden, suggesting that MASLD may serve as an early indicator of inflammatory and metabolic dysfunction before the accumulation of multiple cardiometabolic abnormalities.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH166
Topic
Epidemiology & Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)