We aimed to investigate the correlation and to explore which MAFLD subtypes have the greatest influence on progression of arterial stiffness risk. Using data from a health examination-based cohort, a total of 12,129 participants who underwent two repeated health examinations that included brachial-ankle pulse wave velocity (baPWV) from 2012 to 2020 were enrolled. Participants were separated into non–MAFLD, overweight/obese (OW–MAFLD), lean/normal weight (lean–MAFLD) and diabetes (DM–MAFLD) groups. Among the participants with a median follow–up of 2.17 years, 4511 (37.2%) participants had MAFLD at baseline, among which 3954 (87.7%), 123 (2.7%), and 434 (9.6%) were OW–, lean– and DM–MAFLD, respectively. Analyses using linear regression models confirmed that compared with the non–MAFLD group, the elevated baPWV change rates (cm/s/year) were 12.87 (8.81–16.94), 25.33 (7.84–42.83) and 38.49 (27.88–49.10) in OW, lean and DM–MAFLD, respectively, while the increased change proportions (%) were 1.53 (1.10–1.95), 3.56 (1.72–5.40) and 3.94 (2.82–5.05), respectively. Similar patterns were observed when these two baPWV parameters were transformed in the form of the greatest increase using Cox proportional hazards model analyses. Furthermore, the risk of arterial stiffness progression across MAFLD subtypes presented a significant, gradient, inverse relationship in the order of DM–, lean–, OW with metabolic abnormalities (MA)–, and OW without MA–MAFLD. MAFLD, especially DM–MAFLD and lean–MAFLD, was significantly associated with arterial stiffness progression, providing evidence that stratification screening and surveillance strategies for CVD risk have important clinical implications.

中文翻译：

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代谢功能障碍相关脂肪肝疾病亚型的动脉僵硬度进展：一项前瞻性队列研究

我们的目的是研究相关性并探索哪些 MAFLD 亚型对动脉僵硬风险进展影响最大。利用基于健康检查的队列数据，共有 12,129 名参与者在 2012 年至 2020 年间接受了两次重复的健康检查，其中包括臂踝脉搏波速度 (baPWV)。参与者被分为非 MAFLD、超重/肥胖 (OW-MAFLD)、瘦/正常体重 (lean-MAFLD) 和糖尿病 (DM-MAFLD) 组。在中位随访时间为 2.17 年的参与者中，4511 名（37.2%）参与者在基线时患有 MAFLD，其中 3954 名（87.7%）、123 名（2.7%）和 434 名（9.6%）为 OW-、瘦-和 DM-MAFLD，分别。使用线性回归模型的分析证实，与非 MAFLD 组相比，OW 组的 ba​​PWV 变化率（cm/s/年）升高分别为 12.87（8.81-16.94）、25.33（7.84-42.83）和 38.49（27.88-49.10） 、瘦肉和DM-MAFLD，而增加的变化比例（%）分别为1.53（1.10-1.95）、3.56（1.72-5.40）和3.94（2.82-5.05）。当使用 Cox 比例风险模型分析将这两个 baPWV 参数转换为最大增量形式时，观察到类似的模式。此外，跨 MAFLD 亚型的动脉硬化进展风险呈现显着的梯度反比关系，顺序为 DM–、瘦–、伴有代谢异常 (MA) 的 OW–、以及不伴有 MA–MAFLD 的 OW。 MAFLD，尤其是 DM-MAFLD 和瘦-MAFLD，与动脉僵硬度进展显着相关，这提供了证据表明 CVD 风险的分层筛查和监测策略具有重要的临床意义。