TY - JOUR N1 - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions. This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions. TI - Prevalence, characteristics and outcomes of patients with metabolic and alcohol related/associated liver disease (MetALD): a systematic review and meta-analysis EP - 9 AV - restricted Y1 - 2025/02// VL - 163 JF - Metabolism KW - Science & Technology KW - Life Sciences & Biomedicine KW - Endocrinology & Metabolism KW - MetALD KW - Metabolic dysfunction associated steatotic liver KW - disease KW - Alcohol related liver disease KW - Steatotic liver disease KW - SLD KW - MASLD KW - ALD KW - ALL-CAUSE MORTALITY KW - CARDIOVASCULAR EVENTS KW - PUBLICATION BIAS KW - CONSUMPTION KW - RISK KW - IMPACTS A1 - Tampaki, Maria A1 - Tsochatzis, Emmanouil A1 - Lekakis, Vasileios A1 - Cholongitas, Evangelos ID - discovery10204528 N2 - Background: In light of the new nomenclature of steatotic liver disease (SLD), we aimed to enhance the existing knowledge on the epidemiology and clinical outcomes of metabolic and alcohol related/associated liver disease (MetALD). Methods: A systematic review and meta-analysis were performed in Medline/PubMed, Embase, Scopus and Cochrane databases to evaluate the prevalence and outcomes of MetALD within the SLD population and to compare the characteristics between MetALD patients and those with metabolic dysfunction associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD). Nineteen studies from nine countries that evaluated 4,543,341 adult participants with SLD were included. Results: The pooled overall prevalence of MetALD among the SLD population was 10 % (95%CI:7?13 %) without significant difference between Asian and non-Asian populations. However, MetALD was more frequent in men than women (86 % vs 14 %, p < 0.01), while Asian MetALD patients, were more frequent men (92 % vs 66 %, p < 0.01) compared to non-Asians. Additionally, in terms of metabolic characteristics there were no significant differences between MetALD, MASLD and ALD patients. Regarding outcomes, patients with MetALD, compared to non-SLD, were at increased risk of all-cause [HR 1.44 (95%CI:1.24?1.66)], cardiovascular disease (CVD) [HR 1.17 (95%CI:1.12?1.21)] and cancer-related mortality [HR 2.07 (95%CI:1.32?3.25)]. Finally, patients with MetALD, had increased incidence of CVD and liver decompensating events, compared to non-SLD participants [HR 1.49 (95%CI:1.03?2.15); HR 10.55 (95%CI:3.46?32.16) respectively]. Conclusions: Based on the existing literature, patients with MetALD consist a significant part of the SLD population, with high all-cause, CVD and cancer-related mortality and increased risk for CVD and hepatic decompensation. SN - 0026-0495 PB - W B SAUNDERS CO-ELSEVIER INC UR - https://doi.org/10.1016/j.metabol.2024.156101 ER -