{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T19:08:19Z","timestamp":1778699299606,"version":"3.51.4"},"reference-count":66,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K19796"],"award-info":[{"award-number":["25K19796"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K08313"],"award-info":[{"award-number":["22K08313"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["21K09181"],"award-info":[{"award-number":["21K09181"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K07993"],"award-info":[{"award-number":["23K07993"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is characterized by the presence of hepatic steatosis and at least one of five cardiometabolic risk factors, leading to the development of cardiovascular\u2013kidney\u2013metabolic syndrome including chronic kidney disease (CKD). However, the impact of heterogeneity of MASLD on new onset of CKD remains unclear. We explored the relationship between subgroups of MASLD divided by using a machine learning (ML) model called supervised clustering and the development of CKD during a 10\u2010year follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 12,168 Japanese subjects (men\/women: 7927\/4,241 and mean age: 48\u00a0years) who received annual health examinations including abdominal ultrasonography were recruited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using the supervised clustering by SHapley Additive exPlanations (SHAP) and uniform manifold approximation and projection (UMAP) for steatotic liver diseases, 10 subclusters including 3 distinctive subgroups of MASLD were detected by a Gaussian mixture model. Kaplan\u2013Meier survival curve analysis showed a significant difference in the cumulative incidence for new onset of CKD among the 3 subgroups of MASLD. Among the MASLD subclusters, an obese subgroup with an atherogenic profile of serum lipids as well as high levels of fatty liver index and uric acid was the worst subcluster for the development of CKD in individuals with MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The supervised clustering of MASLD using a SHAP\u2010converted matrix and UMAP reveals phenotypically distinct subpopulations that improved risk stratification for new onset of CKD. An obese subgroup with atherogenic lipid profiles and hyperuricemia in MASLD is associated with an increased risk for the development of CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70127","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T16:20:45Z","timestamp":1769444445000},"page":"762-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring a Subpopulation of MASLD Associated With New Onset of CKD Using Supervised Clustering Techniques"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-8229","authenticated-orcid":false,"given":"Itaru","family":"Hosaka","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery Department of Surgery Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6575-9996","authenticated-orcid":false,"given":"Marenao","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7876-1772","authenticated-orcid":false,"given":"Tatsuya","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"},{"name":"Division of Cellular Physiology and Signal Transduction Department of Physiology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1950-8213","authenticated-orcid":false,"given":"Yukinori","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Sapporo Medical University  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keitaro","family":"Nishizawa","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-2508","authenticated-orcid":false,"given":"Rie","family":"Matsumori","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Aida","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Kawaharata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-7103","authenticated-orcid":false,"given":"Kei","family":"Nakata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"},{"name":"Division of Public Health Department of Social Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-5751","authenticated-orcid":false,"given":"Koki","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1920-2810","authenticated-orcid":false,"given":"Toru","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-1464","authenticated-orcid":false,"given":"Hidemichi","family":"Kouzu","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-2906","authenticated-orcid":false,"given":"Naoya","family":"Yama","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Radiology Department of Radiology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8702-1645","authenticated-orcid":false,"given":"Nagisa","family":"Hanawa","sequence":"additional","affiliation":[{"name":"Department of Health Checkup and Promotion Keijinkai Maruyama Clinic  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0145-3541","authenticated-orcid":false,"given":"Masato","family":"Furuhashi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular\u2010Kidney\u2010Metabolic Medicine Department of Internal Medicine Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13688"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.08.003"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.039"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072\u2010023\u201010543\u20108"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac188"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201027762\u20106"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.123.030269"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001186"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000000520"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2023.101133"},{"key":"e_1_2_13_12_1","article-title":"Metabolic Dysfunction\u2010Associated Steatotic Liver Disease (SLD) and Alcohol\u2010Associated Liver Disease, But Not SLD Without Metabolic Dysfunction, Are Independently Associated With New Onset of Chronic Kidney Disease During a 10\u2010Year Follow\u2010up Period","author":"Mori K.","year":"2024","journal-title":"Hepatology Research"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1253\/circrep.cr\u201025\u20100019"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.125.043173"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16552"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003283\u20101"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.54254\/2755\u20102721\/79\/20241551"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12859\u2010020\u201003564\u20109"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1109\/jbhi.2023.3319551"},{"key":"e_1_2_13_20_1","first-page":"774","volume-title":"16th IEEE International Conference on Tools with Artificial Intelligence","author":"Eick C. F.","year":"2004"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157\u2010018\u20101648\u20101"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.12.034"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0013"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/hvab048"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u2010230x\u20106\u201033"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010019\u20100284\u20109"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u2010s005"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2007.01526.x"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11082108"},{"key":"e_1_2_13_32_1","doi-asserted-by":"crossref","unstructured":"A.Cooper O.Doyle andA.Bourke Supervised Clustering for Subgroup Discovery: An Application to COVID\u201019 Symptomatology (2021) 408\u2013422.","DOI":"10.1007\/978-3-030-93733-1_29"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10845\u2010024\u201002468\u20102"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.1705.07874"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42256\u2010019\u20100138\u20109"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.2012.04456"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.1008432"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1029\/2021ea001680"},{"key":"e_1_2_13_39_1","unstructured":"L.McInnes J.Healy J.Melville\u201cUmap: Uniform Manifold Approximation and Projection for Dimension Reduction.\u201darXiv preprint arXiv:1802.034262018:"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.59170\/stattrans\u20102023\u2010011"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2004.06.015"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12859\u2010022\u201004675\u20101"},{"key":"e_1_2_13_43_1","unstructured":"TaskesenE.\u201cHNet: Graphical Hypergeometric Networks.\u201darXiv preprint arXiv:2005.046792020:"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej21\u20100563"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13293\u2010024\u201000617\u2010z"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201088025\u2010w"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.121.021430"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201092292\u2010y"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13790"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.07.047"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.deman.2023.100191"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2025.2449613"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej24\u20100622"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00378.2020"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010020\u20100532\u2010z"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157\u2010023\u201002318\u20100"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.78.11.6858"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.cj\u201014\u20101267"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2022.04.022"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.cj\u201018\u20100082"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej19\u20100053"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12982"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010021\u201000679\u20101"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells13050450"},{"key":"e_1_2_13_65_1","first-page":"774","volume-title":"16Th IEEE International Conference on Tools with Artificial Intelligence","author":"Eick C. F.","year":"2004"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/genetics\/iyaf068"},{"key":"e_1_2_13_67_1","doi-asserted-by":"crossref","unstructured":"L.McInnes J.Healy J.Melville(2018)UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction.https:\/\/doi.org\/10.48550\/arXiv.1802.03426.","DOI":"10.21105\/joss.00861"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.70127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hepr.70127","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.70127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:24:18Z","timestamp":1778696658000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.70127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":66,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/hepr.70127"],"URL":"https:\/\/doi.org\/10.1111\/hepr.70127","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]},"assertion":[{"value":"2025-08-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}