Gutiérrez-Cuevas J, Sandoval-Rodriguez A, Garcia-Bañuelos J, Petri MH, Armendariz-Borunda J. Interplay between cardiometabolic risk factors in metabolic dysfunction-associated steatotic liver disease: Clinical evidence on cardiovascular disease. World J Gastroenterol 2026; 32(35): 119898 [DOI: 10.3748/wjg.119898]
Corresponding Author of This Article
Jorge Gutiérrez-Cuevas, PhD, Professor, Department of Molecular Biology and Genomics, Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, 950 Sierra Mojada Street, Guadalajara 44340, Jalisco, Mexico. gutierrezcj05@gmail.com
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Gastroenterology & Hepatology
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Gutiérrez-Cuevas J, Sandoval-Rodriguez A, Garcia-Bañuelos J, Petri MH, Armendariz-Borunda J. Interplay between cardiometabolic risk factors in metabolic dysfunction-associated steatotic liver disease: Clinical evidence on cardiovascular disease. World J Gastroenterol 2026; 32(35): 119898 [DOI: 10.3748/wjg.119898]
World J Gastroenterol. Sep 21, 2026; 32(35): 119898 Published online Sep 21, 2026. doi: 10.3748/wjg.119898
Interplay between cardiometabolic risk factors in metabolic dysfunction-associated steatotic liver disease: Clinical evidence on cardiovascular disease
Jorge Gutiérrez-Cuevas, Ana Sandoval-Rodriguez, Jesús Garcia-Bañuelos, Marcelo Heron Petri, Juan Armendariz-Borunda
Jorge Gutiérrez-Cuevas, Ana Sandoval-Rodriguez, Jesús Garcia-Bañuelos, Juan Armendariz-Borunda, Department of Molecular Biology and Genomics, Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
Marcelo Heron Petri, Department of Translational Cardiology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm 17176, Sweden
Marcelo Heron Petri, Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro 70185, Sweden
Marcelo Heron Petri, School of Medical Sciences, Örebro University, Örebro 70362, Sweden
Juan Armendariz-Borunda, Escuela de Medicina y Ciencias de la Salud (EMCS), Tecnologico de Monterrey, Campus Guadalajara, Zapopan 45201, Jalisco, Mexico
Author contributions: Gutiérrez-Cuevas J and Armendariz-Borunda J conceptualized and designed the study, created the artwork, supervised, and made critical revisions; Gutiérrez-Cuevas J, Garcia-Bañuelos J, Sandoval-Rodriguez A, and Petri MH conducted the literature review, did the analysis, interpretation of data and drafted the original manuscript; all authors have read and agreed to the published version of the manuscript.
AI contribution statement: The AI tool (Free AI Grammar Checker) was used exclusively to correct and polish the English grammar.
Supported by the Secretaría de Ciencia, Humanidades, Tecnología e Innovación (SECIHTI), Mexico, No. CF-2023-I-473.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Jorge Gutiérrez-Cuevas, PhD, Professor, Department of Molecular Biology and Genomics, Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, 950 Sierra Mojada Street, Guadalajara 44340, Jalisco, Mexico. gutierrezcj05@gmail.com
Received: February 10, 2026 Revised: April 11, 2026 Accepted: May 18, 2026 Published online: September 21, 2026 Processing time: 190 Days and 8.2 Hours
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease, is the most common liver disease, with a prevalence of 38% in the adult population. MASLD is defined as steatotic liver disease with at least one cardiometabolic risk factor and the absence of harmful alcohol intake. Individuals with MASLD have a high percentage of cardiometabolic comorbidities such as obesity, dyslipidemia, diabetes, and hypertension. Therefore, these patients are at increased risk for the occurrence of cardiovascular disease (CVD), which is the leading cause of death in MASLD patients. There is evidence suggesting links between MASLD and insulin resistance, systemic inflammation, oxidative stress, and endothelial dysfunction in the development of CVD, such as arrhythmia (e.g., atrial fibrillation), atherosclerotic heart disease, cardiomyopathy (e.g., left ventricular dysfunction and hypertrophy), heart failure, venous thrombosis, cardiac conduction defects, and peripheral artery disease. In this review, we highlight how cardiometabolic risk factors link MASLD to the development of CVD, considering insulin resistance, systemic inflammation, oxidative stress, and endothelial dysfunction. Therapeutic strategies are also considered.
Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic liver disease, mostly prevalent in Latin America, associated with the development of cardiovascular disease (CVD). Its management and treatment can be challenging, especially in advanced stages (fibrosis and cirrhosis); thus, this disease should be treated by a multidisciplinary team of hepatologists, cardiologists, and nutritionists (among others) in order to reduce liver-related and cardiovascular risk factors. This comprehensive review provides insight into the clinical evidence of the connection between MASLD and CVD through cardiometabolic risk factors.
