Complementary Cardiohepatic Prognostic Value of Hepatic Steatosis in Cardiovascular-Kidney-Metabolic Syndrome
Authors' conclusion
Hepatic steatosis provided complementary cardiovascular and liver prognostic value beyond CKM staging, supporting its integration for more comprehensive cardiohepatic risk stratification.
Study context
- Population
- UK Biobank participants with cardiovascular-kidney-metabolic (CKM) stages 0 to 3UK Biobank participants with CKM stages 0 to 3
- Participants
- 313,970 participants
- Exposure
- Hepatic steatosis beyond CKM staging, vs neither exposure
- Outcome
- MACEs
- Follow-up
- median 15.7-year follow-up
Methodological detailsUK Biobank
- UK Biobank
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Hepatic steatosis and advanced CKM vs Neither exposure
2.33(2.19–2.47)
Hepatic steatosisnonadvanced CKM (stages 0-2)
1.51(1.48–1.55)
Hepatic steatosisCKM stage 3
1.09(0.97–1.23)
P < 0.001for interaction- Major adverse cardiovascular events (MACEs) occurred
- 32,110
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| MALEs (secondary) · median 15.7-year follow-up | 5.09 (3.97–6.54) | |
| 0.10.31310Hazard ratio (log scale) |
- Major adverse liver events (MALEs) (secondary) — MALEs occurred
- 1,599
- MALEs (secondary) — Proportion of association with CKM stage mediated by hepatic steatosis
- 41.1%
Alternative steatosis measures, liver fibrosis and discrimination
- Findings consistent across alternative steatosis measures
- Liver fibrosis showed no significant stage-dependent association with MACEs and a smaller mediation proportion for MALEs
- Adding hepatic steatosis to CKM staging improved discrimination for both outcomes
Original publication
Complementary Cardiohepatic Prognostic Value of Hepatic Steatosis in Cardiovascular-Kidney-Metabolic Syndrome. JACC Adv. Published 28 October 2026. doi:10.
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