Prevention & lipidsCohort study
Cardiovascular risk in women with metabolic dysfunction-associated steatotic liver disease across the menopausal transition
- Nationwide population-based cohort study
Authors' conclusion
MASLD was associated with increased cardiovascular risk in both premenopausal and postmenopausal women. The absolute excess risk associated with MASLD was larger in postmenopausal women.
Study context
- Population
- Women aged ≥40 years, Korean National Health Insurance Service database; premenopausal and postmenopausal837,363 premenopausal
- Participants
- 1,931,330 women
- Exposure
- MASLD grade 1 or grade 2 vs no MASLD, in premenopausal and postmenopausal women
- Outcome
- MACE:
- MI
- Ischemic stroke
- CV death
Main finding
As reported in the abstract
MACE incidence (per 1,000 person-years) by MASLD grade (no MASLD / grade 1 / grade 2)
| Group | No MASLD | Grade 1 | Grade 2 |
|---|---|---|---|
| Premenopausal | 1.82 | 2.93 | 3.91 |
| Postmenopausal | 7.68 | 10.55 | 12.36 |
Observational data: associations, not effects.
Further findings
| Outcome | Values | absolute risk difference (95% CI) | |
|---|---|---|---|
| Absolute risk difference in MACE vs no MASLD, by menopausal status · 5 years — Grade 1 vs No MASLD · postmenopausal | 0.51% (0.47%–0.55%) | ||
| Absolute risk difference in MACE vs no MASLD, by menopausal status · 5 years — Grade 2 vs No MASLD · postmenopausal | 1.09% (1.02%–1.17%) | ||
| Absolute risk difference in MACE vs no MASLD, by menopausal status · 5 years — Grade 1 vs No MASLD · premenopausal | 0.20% (0.17%–0.22%) | ||
| Absolute risk difference in MACE vs no MASLD, by menopausal status · 5 years — Grade 2 vs No MASLD · premenopausal | 0.42% (0.37%–0.47%) | ||
| −0.500.511.5Difference (linear scale) |
| Outcome | Values | Estimate |
|---|---|---|
| 5-year absolute MACE risk by MASLD grade (no MASLD / grade 1 / grade 2) | Premenopausal No MASLD 0.45% (95% CI 0.44%-0.47%) · Grade 1 0.65% (95% CI 0.62%-0.68%) · Grade 2 0.87% (95% CI 0.82%-0.93%) · Postmenopausal No MASLD 2.74% (95% CI 2.71%-2.77%) · Grade 1 3.25% (95% CI 3.20%-3.30%) · Grade 2 3.83% (95% CI 3.75%-3.91%) |
Absolute risk difference in major adverse cardiovascular events (MACE) vs no MASLD, by menopausal status · 5 years
- Over twice as large in postmenopausal than premenopausal women
Original publication
Cardiovascular risk in women with metabolic dysfunction-associated steatotic liver disease across the menopausal transition. Eur J Prev Cardiol. Published 5 May 2026. doi:10.1093/eurjpc/zwag254
Summarised from the published abstract; every number is checked against it