Comparison of Metabolic Dysfunction-Associated Fatty Liver Disease with Non-Alcoholic Fatty Liver Disease in Identifying Cardiovascular Risk in Chinese Individuals with Rheumatoid Arthritis

Background: The nomenclature from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) is considered to identify more cardiovascular disease (CVD) risk in general population, and patients with rheumatoid arthritis (RA) carry an excess risk for CVD. We aimed to compare MAFLD with NAFLD in identifying CVD risk in RA patients. Methods: : Clinical data from a Chinese RA cohort were retrospectively analyzed. Hepatic steatosis was defined by abdominal ultrasound examination. CVD risk in RA patients was estimated by the Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Results: : Among 513 included RA patients, 78.4% were female and the mean ± SD age was 51.8 ± 12.6 years. The prevalence of MAFLD and NAFLD was 21.4% and 20.5%, respectively. 10.9% RA patients concomitated with CVD events and 32.4% had a high 10-year CVD risk. Multivariate logistic regression analysis showed that both MAFLD and NAFLD were associated with an increase in CVD events (MAFLD: AOR = 2.303; NAFLD: AOR = 2.478) and high 10-year CVD risk (MAFLD: AOR = 3.184; NAFLD: AOR = 2.870, all p < 0.05). The net reclassification index and integrated discrimination improvement indicated no additional CVD events and high 10-years CVD risk were identified when replacing NAFLD with MAFLD in RA patients. Conclusions: : Both MAFLD and NAFLD are associated with an increased CVD risk which implies the importance of early detection and management of MAFLD or NAFLD in RA patients. However, new nomenclature of MAFLD identify no additional CVD risk in RA patients.