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Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular...
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Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 29 September 2025 | Viewed by 6661

Special Issue Editors

Dr. Marcin Kosmalski

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Guest Editor
Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
Interests: non-alcoholic fatty liver disease; metabolic-associated fatty liver disease; diabetes; clinical pharmacology
Special Issues, Collections and Topics in MDPI journals
Dr. Monika Różycka-Kosmalska

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Guest Editor
Department of Electrocardiology, Medical University of Lodz, 92-213 Lodz, Poland
Interests: arrhythmias; intensive cardiac therapy; metabolic disease

Special Issue Information

Dear Colleagues,

Non-alcoholic fatty liver disease (NAFLD), metabolic-dysfunction-associated fatty liver disease (MAFLD), and metabolic-dysfunction-associated steatotic liver disease (MASLD) are some of the most common liver diseases, currently estimated to affect 38% of the global population. NAFLD, MAFLD, and MASLD have different diagnostic definitions and differ in terms of clinical and histological features; however, in everyday medical practice, they all constitute significant medical problems. Their presence is associated with the risk of serious consequences, both in the liver and the cardiovascular system (i.e., CVD). There is a close relationship between NAFLD, MAFLD, and MASLD and CVDs such as hypertension, coronary artery disease, cardiac arrhythmia, and structural heart disease. For this reason, the mentioned liver diseases are classified as the main risk factors for damage to the cardiovascular system. This relationship may be direct or indirect, related to, among others, excess body weight, type 2 diabetes, dyslipidemia, and chronic kidney disease. However, it should be emphasized that there are numerous controversies regarding the diagnostic and therapeutic process of NAFLD/MAFLD/MASLD. They concern the selection of the optimal diagnostic tool as well as an effective therapeutic option that would reduce liver fat and prevent CVD. Despite the proven epidemiological relationship, there is a lack of data on the risk factors for the development of CVD in this group of patients, knowledge of the pathomechanisms leading to this relationship, and therapeutic options, including the treatment and prevention of CVD in patients with NAFLD/MAFDL/MASLD. From a clinical point of view, this issue should be a medical priority due to the frequency of the problem, the presence of numerous controversies, and, above all, the health consequences. Therefore, the aim of our Special Issue will be to answer questions about the relationship between NAFLD, MAFLD, MASLD, and CVD, with particular emphasis on epidemiological data, etiopathogenesis, diagnostic problems, and therapeutic possibilities.

Dr. Marcin Kosmalski
Dr. Monika Różycka-Kosmalska
Guest Editors

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Keywords

  • non-alcoholic fatty liver disease (NAFLD)
  • metabolic-dysfunction-associated fatty liver disease (MAFLD)
  • metabolic-dysfunction-associated steatotic liver disease (MASLD)
  • cardiovascular disease (CVD)
  • cardiac arrhythmias
  • structural heart disease
  • coronary artery disease
  • hypertension

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Published Papers (5 papers)

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Research

16 pages, 457 KiB  
Article
Association Between Sociodemographic Variables, Healthy Habits, and Stress with Risk Scales for Liver Disease Associated with Metabolic Dysfunction
by Ángel Arturo López-González, Emilio Martínez-Almoyna Rifá, Hernán Paublini Oliveira, Cristina Martorell Sánchez, Pedro Juan Tárraga López and José Ignacio Ramírez-Manent
Life 2025, 15(1), 116; https://doi.org/10.3390/life15010116 - 16 Jan 2025
Viewed by 823
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide, with a multifactorial etiology. This study aims to evaluate the associations between various sociodemographic variables, healthy habits, and stress with risk scale values for MAFLD. Materials and [...] Read more.
Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide, with a multifactorial etiology. This study aims to evaluate the associations between various sociodemographic variables, healthy habits, and stress with risk scale values for MAFLD. Materials and Methods: A descriptive, cross-sectional study was conducted on 16,708 Spanish workers to assess how sociodemographic variables (age, gender, and socioeconomic status), healthy habits (smoking, Mediterranean diet adherence, and physical activity), and stress correlate with values from three MAFLD risk scales: fatty liver index (FLI), hepatic steatosis index (HSI), and lipid accumulation product (LAP). Results: All analyzed variables were associated with the values of the three MAFLD risk scales. Among them, the variables showing the strongest associations (represented by odds ratio values) were age and physical activity. Conclusions: The profile of an individual at higher risk of elevated MAFLD risk scale values is a male, aged 50 or older, belonging to lower socioeconomic levels (manual laborers), a smoker, sedentary, with low adherence to the Mediterranean diet, and with high stress scale scores. Full article
(This article belongs to the Special Issue Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease)
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22 pages, 9155 KiB  
Article
Effect of White Tea on Leptin and Asprosin Levels in Rats Feeding a High-Fat Diet
by Adnan Yilmaz, Merve Nur Toraman, Sibel Mataraci Karakas, Zulkar Ozden, Esra Pinarbas and Tolga Mercantepe
Life 2024, 14(12), 1548; https://doi.org/10.3390/life14121548 - 26 Nov 2024
Cited by 1 | Viewed by 1137
Abstract
Background: Currently, obesity affects over 600 million individuals and is responsible for numerous severe health conditions, particularly diabetes and metabolic syndrome. The objective of our study was to examine the impact of white tea, known for its potent antioxidant properties, on the reduction [...] Read more.
Background: Currently, obesity affects over 600 million individuals and is responsible for numerous severe health conditions, particularly diabetes and metabolic syndrome. The objective of our study was to examine the impact of white tea, known for its potent antioxidant properties, on the reduction in body weight as well as the levels of leptin and asprosin. Methods: A total of 72 male Sprague–Dawley rats were randomly assigned to 9 groups, with each group consisting of 8 rats. The groups were partitioned into two in order to examine the preventative and therapeutic effects of white tea on obesity. During this study, the case groups were administered white tea together with a high-fat diet, whereas the positive control group was administered orlistat along with a high-fat diet through oral gavage. After the experiment concluded, the levels of leptin, asprosin, and insulin hormones were evaluated in serum samples collected from rats using the ELISA method. Results: The findings demonstrated that the administration of white tea led to a significant decrease in body weight, serum leptin, and asprosin levels, as well as oxidative stress indicators, in rats that were fed a high-fat diet. Conclusions: Utilizing natural chemicals, such as white tea, which possess minimal side effects and have powerful antioxidant activity, can mitigate the detrimental consequences associated with obesity. Full article
(This article belongs to the Special Issue Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease)
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10 pages, 785 KiB  
Article
Relationship of the Degree of Sarcopenia with the Severity of Nonalcoholic Fatty Liver Disease and Cardiometabolic Risk in Adolescents
by Yoowon Kwon, Jin A Chung, You Jin Choi, Yoo Min Lee, So Yoon Choi, In Hyuk Yoo, Tae Hyeong Kim and Su Jin Jeong
Life 2024, 14(11), 1457; https://doi.org/10.3390/life14111457 - 10 Nov 2024
Viewed by 1318
Abstract
The association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. We investigated sarcopenia’s impact on NAFLD severity and its relationship with cardiometabolic risk in adolescents. We conducted a retrospective study on 122 patients aged 13–18 years and diagnosed with both [...] Read more.
The association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. We investigated sarcopenia’s impact on NAFLD severity and its relationship with cardiometabolic risk in adolescents. We conducted a retrospective study on 122 patients aged 13–18 years and diagnosed with both NAFLD and sarcopenia by laboratory tests, abdominal ultrasound (US), and multifrequency bioelectrical impedance analysis. Sarcopenia was stratified into tertiles based on the skeletal muscle-to-fat ratio (MFR), NAFLD severity was established by the US, and cardiometabolic risk was assessed by the triglyceride–glucose (TyG) index and the atherogenic index of plasma (AIP). Compared with the other patients, those in the lower MFR tertiles exhibited a greater severity of NAFLD (p < 0.001) and significantly higher TyG index and AIP. The independent effect of MFR was observed to have a negative correlation with the severity of NAFLD (p < 0.001). Based on the aforementioned results, the degree of sarcopenia can be considered as one of the risk factors of severe NAFLD and might be an indicator of cardiometabolic risk in adolescents. Weight training to reach the amount of muscle mass could be included in the treatment strategies to improve or prevent NAFLD in adolescents with sarcopenia. Full article
(This article belongs to the Special Issue Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease)
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20 pages, 1202 KiB  
Article
Allelic, Genotypic, and Haplotypic Analysis of Cytokine IL17A, IL17F, and Toll-like Receptor TLR4 Gene Polymorphisms in Metabolic-Dysfunction-Associated Steatotic Liver Disease: Insights from an Exploratory Study
by Sorina-Cezara Coste, Olga Hilda Orășan, Angela Cozma, Vasile Negrean, Teodora Gabriela Alexescu, Mirela Georgiana Perne, George Ciulei, Adriana Corina Hangan, Roxana Liana Lucaciu, Mihaela Iancu and Lucia-Maria Procopciuc
Life 2024, 14(10), 1327; https://doi.org/10.3390/life14101327 - 18 Oct 2024
Cited by 1 | Viewed by 1069
Abstract
(1) Background: Interleukin 17 (IL17) and toll-like receptor 4 (TLR4) elevate the risk of metabolic and liver diseases. (2) Methods: This study’s objective was to explore the association of IL17 and TLR4 gene polymorphisms with MASLD susceptibility and test their effect on serum [...] Read more.
(1) Background: Interleukin 17 (IL17) and toll-like receptor 4 (TLR4) elevate the risk of metabolic and liver diseases. (2) Methods: This study’s objective was to explore the association of IL17 and TLR4 gene polymorphisms with MASLD susceptibility and test their effect on serum IL17 and TLR4 levels. A total of 43 patients with MASLD (MASH/MAFL) and 38 healthy individuals were genotyped for IL17F-A7488G, IL17A-G197A, TLR4-Asp299Gly, and TLR4-Thr399Ile polymorphisms using PCR-RFLP. ELISA methods determined IL17F, IL17A, and TLR4 serum levels. (3) Conclusions: Patients carrying the variant genotypes (A/G + G/G) of IL17-A7448G (OR = 5.25), (G/A + A/A) of IL17-G197A (OR = 10.57), (Asp/Gly + Gly/Gly) of TLR4-Asp299Gly (OR = 3.52), or (Thr/Ile + Ile/Ile) of TLR4-Thr399Ile (OR = 9.87) had significantly increased odds of MASH. Genotype (G/A + A/A) of IL17-G197A was significantly associated with the odds of MAFL (p = 0.0166). Allele A of the IL17-G197A polymorphism was significantly related to increased odds of MAFL (OR = 4.13, p = 0.0133). In contrast, allele A of IL17-G197A (OR = 5.41, p = 0.008), allele Gly of TLR4-Asp299Gly (OR = 3.19, p = 0.046), and allele Ile of TLR4-Thr399Ile (OR = 6.94, p = 0.008) polymorphisms were significantly related to an increased risk of MASH. Allele A of IL17A-G197A, allele Gly of TLR4-Asp299Gly, and allele Ile of TLR4-Thr399Ile gene polymorphisms were significantly associated with the increased odds of MASLD. In patients with MASLD, we found significant influence from the IL17A-G197A gene polymorphism on IL17F levels (p = 0.0343). Full article
(This article belongs to the Special Issue Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease)
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14 pages, 1877 KiB  
Article
Exploring the Th2 Response in Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Potential Modulator of the Renin-Angiotensin System (RAS) Pathway in Hypertension Development
by Lucía Angélica Méndez-García, Galileo Escobedo, Itzel Baltazar-Pérez, Nydia Angélica Ocampo-Aguilera, José Alfonso Arreola-Miranda, Miguel Angel Cid-Soto, Ana Alfaro-Cruz, Antonio González-Chávez, Aquiles Ranferi Ocaña-Guzmán and Helena Solleiro-Villavicencio
Life 2024, 14(9), 1080; https://doi.org/10.3390/life14091080 - 29 Aug 2024
Cited by 1 | Viewed by 1276
Abstract
Non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is alarmingly increasing alongside the cases of obesity worldwide. MASLD is an underestimated metabolic abnormality closely linked with a higher risk of developing systemic arterial hypertension (SAH). However, [...] Read more.
Non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is alarmingly increasing alongside the cases of obesity worldwide. MASLD is an underestimated metabolic abnormality closely linked with a higher risk of developing systemic arterial hypertension (SAH). However, the underlying mechanism of association between MASLD and SAH remains unknown. Inflammation may link these two entities by regulating the renin-angiotensin system (RAS). For this reason, in this study, we evaluated the hepatic expression of a cytokine profile and critical molecules in the RAS pathway in patients with morbid obesity and MASLD, both with SAH. We found a statistically significant correlation between ACE levels and the cytokines IL-4, IL-10, and IL-13 of Th2 response. Furthermore, according to a multiple linear regression analysis, the cytokines IL-4 and IL-13 were the best predictors of ACE levels. Moreover, we observed increased hepatic IL-13 expression in patients with morbid obesity, MASLD, and SAH compared to those without SAH. These results allow us to propose, for the first time, that the Th2 response, through regulating the RAS, could play a critical role in developing SAH in individuals with MASLD and obesity. Full article
(This article belongs to the Special Issue Metabolic Health: The Interplay Between NAFLD, MAFLD, MASLD and Cardiovascular Disease)
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