de Souza MHG, Nogueira PMM, Villela-Nogueira CA. Metabolic dysfunction-associated steatotic liver disease and diabetes: Together against the heart. World J Hepatol 2025; 17(9): 109737 [DOI: 10.4254/wjh.v17.i9.109737]
Corresponding Author of This Article
Cristiane Alves Villela-Nogueira, MD, PhD, Full Professor, School of Medicine, Department of Internal Medicine, Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255 Room 9E16 Cidade Universitária, Rio de Janeiro 21941617, Brazil. crisvillelanog@gmail.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2025; 17(9): 109737 Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.109737
Metabolic dysfunction-associated steatotic liver disease and diabetes: Together against the heart
Matheus Henrique Gonçalves de Souza, Pedro Miguel Mattos Nogueira, Cristiane Alves Villela-Nogueira
Matheus Henrique Gonçalves de Souza, Cristiane Alves Villela-Nogueira, School of Medicine, Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941617, Brazil
Pedro Miguel Mattos Nogueira, Post Graduation Program in Cardiology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941617, Brazil
Pedro Miguel Mattos Nogueira, Department of Internal Medicine, Faculdade de Medicina Souza Marques, Rio de Janeiro 21310310, Brazil
Author contributions: Villela-Nogueira CA designed the overall concept and outline of the manuscript; de Souza MHG, Nogueira PMM, and Villela-Nogueira CA contributed to the writing and editing of the manuscript, and the review of the literature; all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: The authors have any conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cristiane Alves Villela-Nogueira, MD, PhD, Full Professor, School of Medicine, Department of Internal Medicine, Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255 Room 9E16 Cidade Universitária, Rio de Janeiro 21941617, Brazil. crisvillelanog@gmail.com
Received: May 20, 2025 Revised: June 29, 2025 Accepted: July 29, 2025 Published online: September 27, 2025 Processing time: 128 Days and 13.9 Hours
Abstract
Cardiovascular events are the main cause of mortality in individuals with type 2 diabetes mellitus (T2DM) and also in those with metabolic dysfunction-associated steatotic liver disease (MASLD). In this editorial, we comment on the results of a meta-analysis published by Shetty et al that shows an addictive risk for cardiovascular events when both pathologies are together. Patients with MASLD and T2DM have the worst prognosis related to liver disease since they have a higher risk for metabolic dysfunction-associated steatohepatitis, disease progression, and hepatocarcinoma. The meta-analysis included 370013 participants and showed that, although with high heterogeneity, there is a higher prevalence of cardiovascular events in patients with T2DM when MASLD is diagnosed compared to those without MASLD. Hence, MASLD and T2DM may have a new interplay regarding cardiovascular outcomes in addition to the already known liver-related outcomes.
Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, affecting about 38% of adults worldwide. MASLD is closely associated with the growing obesity epidemic and the increasing burden of type 2 diabetes mellitus. These diseases pose a substantial threat to public health, with repercussions ranging from social to economic burden worldwide. Although the conclusion of this meta-analysis has already been displayed in individual articles, this present analysis included 370013 participants and corroborates the interplay between these two epidemic diseases and highlights the importance of adequate screening for cardiovascular and liver disease in this population.
