Glycemic control target for liver and cardiovascular events risk in metabolic dysfunction‐associated steatotic liver disease

• DOI: 10.1111/hepr.14025
• Publication Date: 2024-02-24T13:58:35Z
• Authors: Nobuharu Tamaki; Shun‐Ichi Wakabay...; Takefumi Kimura; Yutaka Yasui; Kaoru Tsuchiya; Hiroyuki Nakanishi; Daniel Q. Huang; Takeji Umemura; Masayuki Kurosaki; Namiki Izumi
• Keywords: Mace; Liver disease

Abstract Aims Optimizing glycemic control may prevent liver‐related events and major adverse cardiovascular (MACE) in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD). However, the optimal hemoglobin A1c (HbA1c) threshold associated a lower risk of complications, particularly as well MACE is unknown. Methods We investigated nationwide population‐based cohort identified 633 279 MASLD, mean follow‐up 4.2 years. Hemoglobin levels were measured annually. The primary endpoint was to determine HbA1c level complications. Results Mean (per 1%) (subdistribution hazard ratio [sHR] 1.26; 95% confidence interval [CI], 1.12–1.42) (sHR 1.36; CI, 1.32–1.41) after adjustment for confounders. Multivariable sHR (95% CI) <5.0%, 6.0%–6.9%, 7.0%–7.9%, 8.0%–8.9%, ≥9.0% (reference, 5.0%–5.9%) 14 (9.1–22), 1.70 (1.2–2.3), 3.32 (2.3–4.8), 3.81 (2.1–6.8), 4.83 (2.4–9.6) events, 1.24 (0.8–1.8), 1.27 (1.2–1.4), (1.5–2.0), 2.36 (1.9–2.9), 4.17 (3.5–5.0) MACE. An 7% selected predicting complications 2.40 [1.8–3.2] 1.98 [1.8–2.2] MACE). Conclusion increased dose‐dependent fashion an increase levels, except <5.0% events. be utilized target MASLD.