eprintid: 10204528 rev_number: 10 eprint_status: archive userid: 699 dir: disk0/10/20/45/28 datestamp: 2025-02-11 15:24:04 lastmod: 2025-02-11 15:24:04 status_changed: 2025-02-11 15:24:04 type: article metadata_visibility: show sword_depositor: 699 creators_name: Tampaki, Maria creators_name: Tsochatzis, Emmanouil creators_name: Lekakis, Vasileios creators_name: Cholongitas, Evangelos title: Prevalence, characteristics and outcomes of patients with metabolic and alcohol related/associated liver disease (MetALD): a systematic review and meta-analysis ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G91 keywords: Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, MetALD, Metabolic dysfunction associated steatotic liver, disease, Alcohol related liver disease, Steatotic liver disease, SLD, MASLD, ALD, ALL-CAUSE MORTALITY, CARDIOVASCULAR EVENTS, PUBLICATION BIAS, CONSUMPTION, RISK, IMPACTS note: 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. abstract: 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. date: 2025-02 date_type: published publisher: W B SAUNDERS CO-ELSEVIER INC official_url: https://doi.org/10.1016/j.metabol.2024.156101 full_text_type: other language: eng verified: verified_manual elements_id: 2345031 doi: 10.1016/j.metabol.2024.156101 medium: Print-Electronic pii: S0026-0495(24)00329-9 lyricists_name: Tsochatzis, Emmanouil lyricists_id: ETSOC40 actors_name: Tsochatzis, Emmanouil actors_id: ETSOC40 actors_role: owner full_text_status: restricted publication: Metabolism volume: 163 article_number: 156101 pages: 9 event_location: United States issn: 0026-0495 citation: Tampaki, Maria; Tsochatzis, Emmanouil; Lekakis, Vasileios; Cholongitas, Evangelos; (2025) Prevalence, characteristics and outcomes of patients with metabolic and alcohol related/associated liver disease (MetALD): a systematic review and meta-analysis. Metabolism , 163 , Article 156101. 10.1016/j.metabol.2024.156101 <https://doi.org/10.1016/j.metabol.2024.156101>. document_url: https://discovery.ucl.ac.uk/id/eprint/10204528/3/Tsochatzis_R2%20MetALD%20send.pdf