{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:55:53Z","timestamp":1781632553567,"version":"3.54.5"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Diabetol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Steatotic liver disease (SLD) is commonly associated with higher burden of cardiometabolic risk factors (CMRFs). This study aimed to examine the associations between CMRF count, patterns and risk of cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 10,121 UK Biobank participants (39% women) with MRI-confirmed liver steatosis. Latent class analysis was used to derive CMRF patterns based on 5 CMRFs (obesity, diabetes, hypertension, high triglycerides and low HDL). Cox models were used to estimate associations between CMRF count and patterns with incidence and mortality of cardiovascular disease (CVD), and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Approximately 95% of SLD participants had\u2009\u2265\u20092 CMRFs. During a median follow-up of 4.9 years, 268 CVD events and 212 deaths were recorded. Higher CMRF count was independently associated with elevated risk of CVD (HR per each additional CMRF: 1.23 (1.08, 1.40)), CVD mortality (1.47 (1.07, 2.02)), and all-cause mortality (1.25 (1.08, 1.44)). Three distinct CMRF patterns were identified, reflecting varying levels of CMRF burden and demographic characteristics. While certain patterns with high CMRF burden were associated with increased CVD risk, the associations were substantially attenuated after adjusting for CMRF count.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CMRF burden is a key determinant of cardiovascular risk in people with SLD, but data-driven CMRF patterns do not improve risk prediction beyond simple counts. CMRF count remains a practical measure of cardiometabolic burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12933-026-03088-1","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T19:34:12Z","timestamp":1769715252000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Measures of comorbid cardiometabolic burden and cardiovascular disease risk in people with MRI-confirmed steatotic liver disease: a prospective cohort study"],"prefix":"10.1186","volume":"25","author":[{"given":"Qi","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinelopi","family":"Manousou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chioma N.","family":"Izzi-Engbeaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"3088_CR1","doi-asserted-by":"publisher","unstructured":"Ho GJK, Tan FXN, Sasikumar NA, Tham EKJ, Ko D, Kim DH et al. High global prevalence of steatotic liver disease and associated subtypes: A meta-analysis. Clin Gastroenterol Hepatol 2025:S1542356525002423. https:\/\/doi.org\/10.1016\/j.cgh.2025.02.006","DOI":"10.1016\/j.cgh.2025.02.006"},{"key":"3088_CR2","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1136\/gutjnl-2024-332917","volume":"73","author":"AH Yang","year":"2024","unstructured":"Yang AH, Tincopa MA, Tavaglione F, Ajmera VH, Richards LM, Amangurbanova M, et al. Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA. Gut. 2024;73:2045\u201353. https:\/\/doi.org\/10.1136\/gutjnl-2024-332917.","journal-title":"Gut"},{"key":"3088_CR3","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1136\/gutjnl-2023-330595","volume":"73","author":"G Targher","year":"2024","unstructured":"Targher G, Byrne CD, Tilg H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut. 2024;73:691\u2013702. https:\/\/doi.org\/10.1136\/gutjnl-2023-330595.","journal-title":"Gut"},{"key":"3088_CR4","doi-asserted-by":"publisher","unstructured":"Feng Q, Izzi-Engbeaya CN, Branch AD, Mullish BH, Manousou P, Woodward M. The relationships between MASLD, extrahepatic Multimorbidity and all-cause mortality in UK biobank cohort. J Clin Endocrinol Metab. 2025;dgaf342. https:\/\/doi.org\/10.1210\/clinem\/dgaf342.","DOI":"10.1210\/clinem\/dgaf342"},{"key":"3088_CR5","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/s12916-025-04288-4","volume":"23","author":"Q Feng","year":"2025","unstructured":"Feng Q, Izzi-Engbeaya C, Manousou P, Woodward M. Extrahepatic disease clusters and mortality in people with steatotic liver diseases: a prospective analysis of 64,749 females and 113,587 males in the UK biobank. BMC Med. 2025;23:450. https:\/\/doi.org\/10.1186\/s12916-025-04288-4.","journal-title":"BMC Med"},{"key":"3088_CR6","doi-asserted-by":"publisher","first-page":"e246","DOI":"10.1016\/j.jhep.2024.02.001","volume":"80","author":"X Fan","year":"2024","unstructured":"Fan X, Zhang B, Shi Y, Liu L, Zhao J. Systemic metabolic abnormalities: key drivers of complications and mortality in MASLD. J Hepatol. 2024;80:e246\u20138. https:\/\/doi.org\/10.1016\/j.jhep.2024.02.001.","journal-title":"J Hepatol"},{"key":"3088_CR7","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1016\/j.jhep.2023.06.003","volume":"79","author":"ME Rinella","year":"2023","unstructured":"Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023;79:1542\u201356. https:\/\/doi.org\/10.1016\/j.jhep.2023.06.003.","journal-title":"J Hepatol"},{"key":"3088_CR8","doi-asserted-by":"publisher","first-page":"e1458","DOI":"10.1210\/clinem\/dgae553","volume":"110","author":"X Zheng","year":"2025","unstructured":"Zheng X, Zhao D, Wang L, Wang Y, Chen Y, Zhang Y. Prevalence of metabolic Dysfunction-associated steatotic liver disease and cardiometabolic risk factor in US adolescents. J Clin Endocrinol Metab. 2025;110:e1458\u201365. https:\/\/doi.org\/10.1210\/clinem\/dgae553.","journal-title":"J Clin Endocrinol Metab"},{"key":"3088_CR9","doi-asserted-by":"publisher","unstructured":"Lee BP, Molina J, Kim S, Dodge JL, Terrault NA. Association of alcohol and incremental cardiometabolic risk factors with liver disease: a National Cross-sectional study. 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Nutr Metab Cardiovasc Dis. 2024;34:2085\u201394. https:\/\/doi.org\/10.1016\/j.numecd.2024.05.018.","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"3088_CR12","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3350\/cmh.2023.0515","volume":"30","author":"M Iwaki","year":"2024","unstructured":"Iwaki M, Fujii H, Hayashi H, Toyoda H, Oeda S, Hyogo H, et al. Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: a sub-analysis of the CLIONE study. Clin Mol Hepatol. 2024;30:225\u201334. https:\/\/doi.org\/10.3350\/cmh.2023.0515.","journal-title":"Clin Mol Hepatol"},{"key":"3088_CR13","doi-asserted-by":"publisher","first-page":"101388","DOI":"10.1016\/j.jhepr.2025.101388","volume":"7","author":"H Park","year":"2025","unstructured":"Park H, Cheuk-Fung Yip T, Yoon EL, Lai-Hung Wong G, Lee HS, Wai-Sun Wong V, et al. Impact of cardiometabolic risk factors on hepatic fibrosis and clinical outcomes in MASLD: a population-based multi-cohort study. JHEP Rep. 2025;7:101388. https:\/\/doi.org\/10.1016\/j.jhepr.2025.101388.","journal-title":"JHEP Rep"},{"key":"3088_CR14","doi-asserted-by":"publisher","first-page":"156306","DOI":"10.1016\/j.metabol.2025.156306","volume":"170","author":"DJ Cuthbertson","year":"2025","unstructured":"Cuthbertson DJ, Kennedy OJ, Bilson J, Hydes TJ, Targher G, Glyn-Owen K, et al. Impact of metabolic dysfunction severity in steatotic liver disease and its interaction with liver fibrosis on all-cause mortality and multiple hepatic and extra-hepatic outcomes. Metabolism. 2025;170:156306. https:\/\/doi.org\/10.1016\/j.metabol.2025.156306.","journal-title":"Metabolism"},{"key":"3088_CR15","doi-asserted-by":"publisher","first-page":"101193","DOI":"10.1016\/j.jhepr.2024.101193","volume":"6","author":"J Pustjens","year":"2024","unstructured":"Pustjens J, Van Kleef LA, Janssen HLA, De Knegt RJ, Brouwer WP. Differential prevalence and prognostic value of metabolic syndrome components among patients with MASLD. 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Front Nutr. 2022;9:831470. https:\/\/doi.org\/10.3389\/fnut.2022.831470.","journal-title":"Front Nutr"}],"container-title":["Cardiovascular Diabetology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12933-026-03088-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-026-03088-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-026-03088-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:21:49Z","timestamp":1781630509000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12933-026-03088-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3088"],"URL":"https:\/\/doi.org\/10.1186\/s12933-026-03088-1","relation":{},"ISSN":["1475-2840"],"issn-type":[{"value":"1475-2840","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"16 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"UK Biobank has obtained Research Tissue Bank approval from its governing Research Ethics Committee, as recommended by the National Research Ethics Service. This research has been conducted using the UK Biobank Resource (application No. 74018). Permission to use the UK Biobank Resource was approved by the access subcommittee of the UK Biobank Board. Consent to participate has been obtained from all UK Biobank participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"64"}}