Association Between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Short-Term Progression of Carotid Atherosclerosis Among Early Middle Age Adults.

Background: The association between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the development of new carotid plaque in young adults requires further evidence from prospective studies. Methods: In this study, young adults underwent abdominal and a carotid ultrasounds measurement were included. The carotid plaque progression was assessed in 2 years after baseline. MASLD is defined according to the liver ultrasound findings and self-reported alcohol consumption. Stepped adjusting multivariable logistic regression were employed to analyze the association between MASLD and the outcome. Subgroup analysis was conducted among sex and different amount of metabolic risk factors. Results: A total of 36.54% (2411/6598) of all participants had MASLD at baseline. Among them, 626 (9.49%) participants were found new onset of carotid plaque in two years. Subjects who had progression of plaque had higher proportion of MASLD (53.99% vs 34.71%, SMD=0.396). Statistically significant positive associations were observed in unadjusted logistic regression models in overall or each sex, respectively. After fully adjustment, the association was only significant among female (OR:2.19, 95% CI: 1.28-3.72) and those had no metabolic risk factor (OR:1.67,95% CI:1.01-2.76). No significant associations were identified in all male subgroups, whereas the associations were still existing among female subgroups. Conclusion: MASLD was found to be a risk factor of progression of carotid plaque among females and those who had not suffered from metabolic risk factor. Prevention should be focused on young adults who have MASLD at physical examination to reduce their risk of future atherosclerosis.