To examine the integration of metabolic dysfunction–associated steatotic liver disease (MASLD) within the cardiovascular-kidney-metabolic (CKM) health framework and its implications for cardiovascular disease (CVD) risk assessment, emphasizing the significance of MASLD in CVD risk.
Key Findings:
FLI ≥ 60 was associated with a 32% higher hazard of CVD events, indicating that higher FLI correlates with increased risk across all CKM stages, particularly in earlier stages.
Interpretation:
Integrating MASLD metrics into CKM staging may improve early risk stratification for CVD, but further research is needed to validate the clinical utility of FLI and its incremental value over existing CVD risk assessments, particularly in diverse populations.
Limitations:
FLI is a surrogate marker and not recommended for individual clinical use.
Potential misclassification of CKM stages due to unavailable components.
Stage 4 CKM overlaps with CVD outcomes, complicating the analysis.
Conclusion:
The integration of MASLD into CKM health could enhance prevention strategies, but questions remain regarding the clinical applicability of FLI and its impact on treatment decisions, underscoring the need for further investigation.
