{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:21:56Z","timestamp":1785410516101,"version":"3.56.0"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Robert Winn Career Development Award"},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92025D00012"],"award-info":[{"award-number":["75N92025D00012"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"award":["75N92025D00012"],"award-info":[{"award-number":["75N92025D00012"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and related fibrosis are increasingly prevalent conditions. The relation of the American Heart Association\u2019s (AHA) cardiovascular health (CVH) metric Life\u2019s Essential 8 (LE8) with MASLD, MetALD, and hepatic fibrosis remains unclear. We aimed to investigate the associations of CVH with MASLD, MetALD, and hepatic fibrosis. Methods: We defined significant hepatic fibrosis as a liver stiffness \u22658.2 kPa measured by vibration-controlled transient elastography. MASLD was defined as steatosis (controlled attenuation parameter of \u2265274 dB\/m) with \u22651 cardiometabolic risk factor and mild alcohol intake (\u2264140 g\/week [women]; \u2264210 g\/week [men]). MetALD was defined as steatosis with \u22651 cardiometabolic risk factor and moderate alcohol intake (141\u2013350 g\/week [women]; 211\u2013420 g\/week [men]). Data from 2962 participants in the Framingham Heart Study (mean age 59 years, 57% women) were used in multivariable-adjusted logistic regression models, accounting for demographic and clinical covariates to relate CVH and liver outcomes. Results: Our study included 2704 participants with mild and 258 with moderate alcohol use. MASLD and MetALD prevalence was 34% and 40%, respectively, and 9% had significant hepatic fibrosis. Each 10-point increase in LE4 score (composite of diet, sleep health, physical activity, and smoking) was associated with 16% lower odds of MASLD (Odds Ratio [OR] 0.84; 95% CI: 0.80\u20130.90; p &lt; 0.001) but not MetALD. Each 10-point increase in LE8 score was associated with 17% lower odds of hepatic fibrosis (OR 0.83; 95% CI: 0.78\u20130.89; p &lt; 0.001). Conclusions: Better CVH is related to lower odds of MASLD and significant hepatic fibrosis.<\/jats:p>","DOI":"10.3390\/nu18081276","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:24:51Z","timestamp":1776435891000},"page":"1276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Life\u2019s Essential 8 with Hepatic Fibrosis, MASLD, and MetALD in the Framingham Heart Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Alejandro","family":"Campos","sequence":"first","affiliation":[{"name":"Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenton","family":"Prescott","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7478-7203","authenticated-orcid":false,"given":"Jiantao","family":"Ma","sequence":"additional","affiliation":[{"name":"Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6510-9360","authenticated-orcid":false,"given":"Madeleine G.","family":"Haff","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9935-4113","authenticated-orcid":false,"given":"Maura E.","family":"Walker","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA"},{"name":"Department of Health Sciences, Sargent College of Health and Rehabilitation, Boston University, Boston, MA 02215, USA"},{"name":"Boston University and NHLBI\u2019s Framingham Study, Framingham, MA 01702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7352-621X","authenticated-orcid":false,"given":"Vanessa","family":"Xanthakis","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA"},{"name":"Boston University and NHLBI\u2019s Framingham Study, Framingham, MA 01702, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1056\/NEJMra2412865","article-title":"Metabolic Dysfunction\u2013Associated Steatotic Liver Disease","volume":"393","author":"Targher","year":"2025","journal-title":"N. 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