最近，术语从非酒精性脂肪性肝病（NAFLD）到代谢功能障碍相关脂肪肝病（MAFLD）和代谢功能障碍相关脂肪肝病（MASLD）的变化强调了肝脂肪变性和代谢功能障碍之间的联系，消除了脂肪肝的耻辱。我们比较了 NAFLD 和 MAFLD 定义对总体死亡率和心血管 (CV) 死亡率、肝脏相关事件 (LRE)、非致命性 CV 事件 (CVE)、慢性肾病 (CKD) 和肝外癌症风险的影响(EHC)。我们系统地检索了四个大型电子数据库进行队列研究（截至 2023 年 8 月发布），这些研究同时使用 NAFLD 和 MAFLD 定义来检查与这两种定义相关的死亡率和不良 CV、肾脏或肿瘤结果的风险。总共确定了 21 项符合条件的队列研究。使用随机效应模型进行荟萃分析。与 NAFLD 患者相比，MAFLD 患者的总体死亡率（随机效应 OR 1.12，95% CI 1.04-1.21，p = .004）和 CV 死亡率显着更高（随机效应 OR 1.15，95% CI 1.04-1.26，p = .004），以及 CKD 发病率较高的边际趋势（随机效应 OR 1.06，95% CI 1.00-1.12，p = .058）和 EHC事件（随机效应 OR 1.11，95% CI 1.00-1.23，p = .052）。我们发现 MAFLD 和 NAFLD 之间的风险 LRE 和非致命性 CVE 没有显着差异。荟萃回归分析确定，与 NAFLD 相比，男性性别和代谢合并症是与 MAFLD 不良临床结果风险相关的最强风险因素。与 NAFLD 相比，MAFLD 患者的总体死亡率和心血管死亡率更高，发生 CKD 和 EHC 事件的比率也更高。患有 NAFLD 的人，可能是由于与 MAFLD 相关的代谢障碍风险状况。© 2024 作者。约翰·威利 (John Wiley) 出版的《肝脏国际》

The recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) highlights the link between hepatic steatosis and metabolic dysfunction, taking out the stigmata of alcohol.We compared the effects of NAFLD and MAFLD definitions on the risk of overall and cardiovascular (CV) mortality, liver-related events (LRE), nonfatal CV events (CVE), chronic kidney disease (CKD), and extra-hepatic cancers (EHC).We systematically searched four large electronic databases for cohort studies (published through August 2023) that simultaneously used NAFLD and MAFLD definitions for examining the risk of mortality and adverse CV, renal, or oncological outcomes associated with both definitions. In total, 21 eligible cohort studies were identified. Meta-analysis was performed using random-effects modelling.Compared with those with NAFLD, individuals with MAFLD had significantly higher rates of overall mortality (random-effect OR 1.12, 95% CI 1.04-1.21, p = .004) and CV mortality (random-effect OR 1.15, 95% CI 1.04-1.26, p = .004), and a marginal trend towards higher rates of developing CKD (random-effect OR 1.06, 95% CI 1.00-1.12, p = .058) and EHC events (random-effect OR 1.11, 95% CI 1.00-1.23, p = .052). We found no significant differences in the risk LREs and nonfatal CVE between MAFLD and NAFLD. Meta-regression analyses identified male sex and metabolic comorbidities as the strongest risk factors related to the risk of adverse clinical outcomes in MAFLD compared to NAFLD.Individuals with MAFLD have higher rates of overall and CV mortality and higher rates of developing CKD and EHC events than those with NAFLD, possibly due to the dysmetabolic risk profile related to MAFLD.© 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.