{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:56:35Z","timestamp":1791831395628,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction\u2010associated fatty liver disease (MAFLD) and metabolic dysfunction\u2010associated steatotic liver disease (MASLD) highlights the link between hepatic steatosis and metabolic dysfunction, taking out the stigmata of alcohol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We compared the effects of NAFLD and MAFLD definitions on the risk of overall and cardiovascular (CV) mortality, liver\u2010related events (LRE), nonfatal CV events (CVE), chronic kidney disease (CKD), and extra\u2010hepatic cancers (EHC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Study Selection<\/jats:title>\n                    <jats:p>We systematically searched four large electronic databases for cohort studies (published through August 2023) that simultaneously used NAFLD and MAFLD definitions for examining the risk of mortality and adverse CV, renal, or oncological outcomes associated with both definitions. In total, 21 eligible cohort studies were identified. Meta\u2010analysis was performed using random\u2010effects modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with those with NAFLD, individuals with MAFLD had significantly higher rates of overall mortality (random\u2010effect OR 1.12, 95% CI 1.04\u20131.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004) and CV mortality (random\u2010effect OR 1.15, 95% CI 1.04\u20131.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004), and a marginal trend towards higher rates of developing CKD (random\u2010effect OR 1.06, 95% CI 1.00\u20131.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.058) and EHC events (random\u2010effect OR 1.11, 95% CI 1.00\u20131.23,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.052). We found no significant differences in the risk LREs and nonfatal CVE between MAFLD and NAFLD. Meta\u2010regression analyses identified male sex and metabolic comorbidities as the strongest risk factors related to the risk of adverse clinical outcomes in MAFLD compared to NAFLD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Individuals with MAFLD have higher rates of overall and CV mortality and higher rates of developing CKD and EHC events than those with NAFLD, possibly due to the dysmetabolic risk profile related to MAFLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.16075","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T05:09:19Z","timestamp":1724044159000},"page":"2939-2949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Clinical outcomes of\n                    <scp>MAFLD<\/scp>\n                    versus\n                    <scp>NAFLD<\/scp>\n                    : A meta\u2010analysis of observational studies"],"prefix":"10.1111","volume":"44","author":[{"given":"Grazia","family":"Pennisi","sequence":"first","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Infantino","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Celsa","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9499-9860","authenticated-orcid":false,"given":"Gabriele","family":"Di\u00a0Maria","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Enea","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Economiche, Aziendali e Statistiche University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Economiche, Aziendali e Statistiche University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Cannella","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Ciccioli","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"La\u00a0Mantia","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6329","authenticated-orcid":false,"given":"Alessandro","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Mercurio","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Tilg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology &amp; Metabolism Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-3900","authenticated-orcid":false,"given":"Giovanni","family":"Targher","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Verona  Verona Italy"},{"name":"Metabolic Diseases Research Unit IRCCS Sacro Cuore\u2014Don Calabria Hospital  Negrar di Valpolicella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6397-4206","authenticated-orcid":false,"given":"Vito","family":"Di\u00a0Marco","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9224-1914","authenticated-orcid":false,"given":"Calogero","family":"Camm\u00e0","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0822-9673","authenticated-orcid":false,"given":"Salvatore","family":"Petta","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.039"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.968766"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2021.0327"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32499"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab339"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.693507"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-022-07508-6"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12898"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.01.013"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0245762"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab641"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-021-10157-y"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.12.022"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-021-01828-6"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl210256"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.14218\/JCTH.2022.00154"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101344"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac188"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154433"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13678"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-27762-6"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15674"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.04.014"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.043"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00308-3"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323082"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324191"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02553-8"},{"key":"e_1_2_11_33_2","doi-asserted-by":"crossref","unstructured":"Erratum in: Nat Med. 2024 Apr;30(4):1212. doi:10.1038\/s41591-024-02817-x","DOI":"10.1038\/s41591-024-02817-x"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14548"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v15.i8.985"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-328224"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16763"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2023.102780"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.08.024"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420188221145549"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.043"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000616"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15695"}],"updated-by":[{"DOI":"10.1111\/liv.70767","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000}}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.16075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T03:10:35Z","timestamp":1729653035000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.16075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,19]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/liv.16075"],"URL":"https:\/\/doi.org\/10.1111\/liv.16075","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,19]]},"assertion":[{"value":"2024-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}