{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:33:39Z","timestamp":1788791619895,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated fatty liver disease (MAFLD) encompasses heterogeneous fatty liver diseases associated with metabolic disorders. We aimed to evaluate the association between MAFLD and extrahepatic malignancies based on MAFLD subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide cohort study included 9\u2009298\u2009497 patients who participated in a health\u2010screening programme of the National Health Insurance Service of Korea in 2009. Patients were further classified into four subgroups: non\u2010MAFLD, diabetes mellitus (DM)\u2010MAFLD, overweight\/obese\u2010MAFLD and lean\u2010MAFLD. The primary outcome was the development of any primary extrahepatic malignancy, while death, decompensated liver cirrhosis and liver transplantation were considered competing events. The secondary outcomes included all\u2010cause and extrahepatic malignancy\u2010related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 2\u2009500\u2009080 patients were diagnosed with MAFLD. During a median follow\u2010up of 10.3\u2009years, 447\u2009880 patients (6.0%) with extrahepatic malignancies were identified. The DM\u2010MAFLD (adjusted subdistribution hazard ratio [aSHR]\u2009=\u20091.13; 95% confidence interval [CI]\u2009=\u20091.11\u20131.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and the lean\u2010MAFLD (aSHR\u2009=\u20091.12; 95% CI\u2009=\u20091.10\u20131.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) groups were associated with higher risks of extrahepatic malignancy than the non\u2010MAFLD group. However, the overweight\/obese\u2010MAFLD group exhibited a similar risk of extrahepatic malignancy compared to the non\u2010MAFLD group (aSHR\u2009=\u20091.00; 95% CI\u2009=\u2009.99\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.42). These findings were reproduced in several sensitivity analyses. The DM\u2010MAFLD was an independent risk factor for all\u2010cause mortality (adjusted hazard ratio [aHR]\u2009=\u20091.41; 95% CI\u2009=\u20091.40\u20131.43;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and extrahepatic malignancy\u2010related mortality (aHR\u2009=\u20091.20; 95% CI\u2009=\u20091.17\u20131.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The diabetic or lean subtype of MAFLD was associated with a higher risk of extrahepatic malignancy than non\u2010MAFLD. As MAFLD comprises a heterogeneous population, appropriate risk stratification and management based on the MAFLD subtypes are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.15832","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T07:38:41Z","timestamp":1705477121000},"page":"799-810","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Extrahepatic malignancies in metabolic dysfunction\u2010associated fatty liver disease: A nationwide cohort study"],"prefix":"10.1111","volume":"44","author":[{"given":"Min Kyung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon Haeng","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye\u2010Sung","family":"Moon","sequence":"additional","affiliation":[{"name":"RexSoft Inc.  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