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Their combined effect on the long\u2010term risk of cardiometabolic multimorbidity (CMM; \u2265\u20092 of diabetes, hypertension, coronary heart disease, and stroke) and cardiac remodelling remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined cross\u2010sectional associations between PS and the severity of MASLD histology in a biopsy\u2010proven MASLD cohort from China. Subsequently, using the UK Biobank, we assessed the long\u2010term risk of developing both incident CMM and cardiac structural\/functional alterations (via cardiac magnetic resonance [CMR]) associated with single\u2010organ versus dual\u2010organ steatosis. Exploratory proteomic profiling was performed to identify potential molecular pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the biopsy\u2010proven cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009482), both continuous pancreatic proton density fat fraction and PS status were associated with severe hepatic steatosis, lobular inflammation, and fibrosis (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the UK Biobank cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916\u2009408; median follow\u2010up of 5.6\u2009years), the coexistence of MASLD and PS additively increased the risk of new\u2010onset CMM (HR\u2009=\u20092.013, 95% CI: 1.219\u20133.322,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Dual\u2010organ steatosis was also associated with marked cardiac alterations, specifically increased left ventricular mass and impaired ventricular function. Proteomics revealed upregulation of lysosomal catabolic and glycosaminoglycan\u2010degrading pathways in dual\u2010organ steatosis compared to single\u2010organ steatosis. Gene Ontology highlighted heparan sulphate proteoglycan catabolism as a hallmark of dual\u2010organ involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PS is associated with greater severity of MASLD histology, and the concomitant involvement of both the liver and pancreas drives a higher risk of CMM and cardiac remodelling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70548","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:10:08Z","timestamp":1771056608000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Liver\u2010Pancreas Fat Deposition: Impact on Cardiometabolic Multimorbidity and Cardiac Dysfunction"],"prefix":"10.1111","volume":"46","author":[{"given":"Li\u2010You","family":"Lian","sequence":"first","affiliation":[{"name":"MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"},{"name":"Institute of Hepatology, Wenzhou Medical University  Wenzhou China"},{"name":"Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyi","family":"Xia","sequence":"additional","affiliation":[{"name":"Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging &amp; Interventional Radiology (Southeast University), Department of Radiology Zhongda Hospital, Medical School of Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong\u2010Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai\u2010Yun","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8534-0818","authenticated-orcid":false,"given":"Xiao\u2010Dong","family":"Zhou","sequence":"additional","affiliation":[{"name":"MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"},{"name":"Institute of Hepatology, Wenzhou Medical University  Wenzhou China"},{"name":"Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province  Wenzhou 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D.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Southampton National Institute for Health and Care Research, Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-5954","authenticated-orcid":false,"given":"Yee Hui","family":"Yeo","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology, Cedars\u2010Sinai Medical Center  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenghong","family":"Ju","sequence":"additional","affiliation":[{"name":"Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging &amp; Interventional Radiology (Southeast University), Department of Radiology Zhongda Hospital, Medical School of Southeast University  Nanjing 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