Table 3.
Estimates of 10-year risk of cardiovascular events, prevalence of myocardial infarction, and prevalence of strokes in US adults, by MAFLD and NAFLD status, from 1999 to 2016.
| Items | 1999–2002 | 2003–2006 | 2007–2010 | 2011–2016 | Total | Ptrend | Pinteraction | P∗ | β or OR (95% CI)† |
| 10-year risk of cardiovascular events | |||||||||
| Framingham | |||||||||
| MAFLD | 14.5 (13.5, 15.4) | 13.4 (12.6, 14.1) | 12.3 (11.5, 13.1) | 13.1 (12.3, 14.0) | 13.2 (12.8, 13,7) | 0.001 | 0.760 | 0.001 | 3.7 (3.4, 4.1) |
| NAFLD | 14.1 (13.1, 15.1) | 13.0 (12.2, 13.8) | 12.3 (11.5, 13.1) | 12.6 (11.8, 13.4) | 12.9 (12.4, 13.3) | <0.001 | 0.385 | 3.2 (2.8, 3.6) | |
| Non-MAFLD | 7.5 (7.0, 8.0) | 7.0 (6.5, 7.4) | 6.7 (6.3, 7.2) | 7.1 (6.7, 7.6) | 7.1 (6.9, 7.3) | <0.001 | |||
| Non-NAFLD | 7.9 (7.4, 8.4) | 7.3 (6.8, 7.8) | 7.0 (6.5, 7.4) | 7.7 (7.2, 8.2) | 7.5 (7.2, 7.7) | <0.001 | |||
| ASCVD | |||||||||
| MAFLD | 11.8 (10.6, 12.9) | 11.0 (10.0, 11.9) | 10.3 (9.4, 11.3) | 10.5 (9.9, 11.1) | 10.8 (10.4, 11.2) | 0.001 | 0.755 | 0.326 | 2.5 (2.2, 2.9) |
| NAFLD | 11.8 (10.5, 13.0) | 10.9 (9.8, 12.0) | 10.4 (9.4, 11.3) | 10.3 (9.7, 10.9) | 10.7 (10.3, 11.1) | <0.001 | 0.625 | 2.2 (1.8, 2.6) | |
| Non-MAFLD | 7.2 (6.7, 7.7) | 6.3 (5.8, 6.8) | 6.2 (5.7, 6.7) | 6.7 (6.2, 7.2) | 6.6 (6.4, 6.9) | <0.001 | |||
| Non-NAFLD | 7.4 (6.9, 7.9) | 6.5 (6.0, 6.9) | 6.3 (5.8, 6.8) | 7.1 (6.5, 7.6) | 6.8 (6.6, 7.1) | <0.001 | |||
| Previous myocardial infarction | |||||||||
| MAFLD | 5.4 (4.0, 7.1) | 6.3 (4.9, 8.1) | 6.1 (5.2, 7.2) | 4.9 (3.8, 6.2) | 5.5 (4.9, 6.3) | 0.297 | 0.374 | 0.360 | 1.79 (1.50, 2.13) |
| NAFLD | 5.5 (4.1, 7.4) | 6.5 (5.0, 8.4) | 6.1 (5.2, 7.1) | 5.0 (4.0, 6.2) | 5.6 (5.0, 6.3) | 0.239 | 0.316 | 1.78 (1.50, 2.11) | |
| Non-MAFLD | 2.3 (1.7, 3.1) | 2.3 (1.7, 3.1) | 2.5 (1.9, 3.3) | 2.4 (1.8, 3.2) | 2.4 (2.0, 2.7) | 0.930 | |||
| Non-NAFLD | 2.3 (1.7, 3.1) | 2.4 (1.8, 3.2) | 2.6 (2.0, 3.5) | 2.4 (1.8, 3.3) | 2.4 (2.1, 2.8) | 0.908 | |||
| Previous stroke | |||||||||
| MAFLD | 3.9 (2.6, 5.7) | 4.7 (3.6, 6.2) | 4.0 (2.9, 5.4) | 3.6 (2.9, 4.5) | 4.0 (3.4, 4.6) | 0.293 | 0.024 | 0.512 | 1.63 (1.32, 2.01) |
| NAFLD | 4.2 (2.9, 6.2) | 4.8 (3.6, 6.4) | 3.9 (2.8, 5.4) | 3.6 (2.8, 4.6) | 4.0 (3.4, 4.7) | 0.141 | 0.010 | 1.60 (1.27, 2.02) | |
| Non-MAFLD | 1.4 (1.0, 2.0) | 2.2 (1.6, 2.9) | 2.1 (1.6, 2.8) | 2.4 (1.8, 3.1) | 2.1 (1.8, 2.4) | 0.038 | |||
| Non-NAFLD | 1.3 (0.9, 1.9) | 2.2 (1.6, 3.0) | 2.2 (1.6, 3.0) | 2.5 (1.9, 3.3) | 2.1 (1.8, 2.4) | 0.022 | |||
Data are from the NHANESs between 1999 and 2016. Data are expressed as percentage (95% CI). All analyses were adjusted for age, sex, and race or ethnic group. Ten-year cardiovascular risks were calculated using Framingham and ASCVD risk scores. Ptrend was calculated for the MAFLD status group by including a continuous variable for the midpoint of each survey period in logistic regression models; significant values indicated variation over time within MAFLD groups. Significant Pinteraction values indicate varying associations between prevalence estimates over time across MAFLD groups. ∗MAFLD vs. NAFLD. †MAFLD vs. non-MAFLD or non-NAFLD. ASCVD: Atherosclerotic Cardiovascular Disease guidelines (from the American Heart Association and American College of Cardiology); CI: Confidence interval; MAFLD: Metabolic associated fatty liver disease; NHANESs: National Health and Nutrition Examination Surveys; NAFLD: Non-alcoholic fatty liver disease; OR: Odds ratio.