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Cardiovascular–kidney–metabolic syndrome and the risk of liver fibrosis progression and liver-related events in MASLD
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Background:
Cardiovascular-kidney-metabolic (CKM) syndrome, a new framework integrating cardiovascular, renal, and metabolic dysfunction, remains inadequately characterized in metabolic dysfunction–associated steatotic liver disease (MASLD).
Objective:
We investigated the relationships between CKM stages and liver fibrosis severity, progression, and the risk of liver-related events (LREs) in MASLD.
CONCLUSIONS
In patients with MASLD, advanced liver fibrosis becomes more prevalent as CKM stages worsen. Higher CKM stages are significantly and independently associated with an increased risk of liver stiffness progression and incidence of long-term LREs. These findings highlight a close interconnection between the progression of cardiometabolic, renal, and liver diseases. Therefore, assessing and monitoring liver fibrosis should be integrated into routine care for all patients with MASLD and advanced CKM stages. Emerging pharmacotherapies (such as incretin-based therapies and SGLT2 inhibitors) show promise for improving both liver-related and cardiovascular-renal outcomes, thus supporting the potential value of a more integrated management approach for this patient population.
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