Cardiovascular Risk in MASLD: Evidence From Epidemiology, Genetics, and Mechanisms

Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with increased cardiovascular risk, yet whether it independently confers risk beyond established cardiometabolic factors remains debated. Herein, we critically appraise epidemiological, genetic, mechanistic, and large-cohort evidence. Many studies reporting independent associations are limited by small sample sizes, heterogeneous cardiovascular outcomes, potential selection and publication bias, and perhaps most importantly, incomplete adjustment for established continuous cardiovascular risk factors.