Longitudinal changes in cardiometabolic risk factors are associated with changes in liver stiffness in adults with MASLD

BACKGROUND & AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by cardiometabolic risk factors (CMRFs). Treatment of CMRFs is the cornerstone of MASLD management, yet other than weight loss, the association between changes in CMRFs and changes in liver-related measures is not defined. This study aimed to characterize these longitudinal associations using non-invasive measurements of hepatic fibrosis and steatosis. METHODS: Adult participants from the NASH CRN prospective study with biopsy-proven MASLD and at least two sequential vibration-controlled transient elastography (VCTE) exams (≥1 year apart) were included. Annual changes in CMRF parameters were compared against annual changes in liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) using adjusted mixed-effects multinomial logistic regression. The primary outcome was LSM change ≥25% (compared to a reference group of no change, or