GBD 2021 Forecasting Collaborators. Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet 403, 2204–2256 (2024).

Cardiovascular diseases (CVDs). World Health Organization https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (2021).

Chew, N. W. S. et al. The genetic interactions between non-alcoholic fatty liver disease and cardiovascular diseases. Front. Genet. 13, 971484 (2022).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Stahl, E. P. et al. Nonalcoholic fatty liver disease and the heart: JACC state-of-the-art review. J. Am. Coll. Cardiol. 73, 948–963 (2019).

Article  PubMed  Google Scholar 

Rinella, M. E. et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology 78, 1966–1986 (2023).

Article  PubMed  Google Scholar 

Lauridsen, B. K. et al. Liver fat content, non-alcoholic fatty liver disease, and ischaemic heart disease: Mendelian randomization and meta-analysis of 279,013 individuals. Eur. Heart J. 39, 385–393 (2018).

Article  CAS  PubMed  Google Scholar 

Chew, N. W. S. et al. Cardiovascular–liver–metabolic health: recommendations in screening, diagnosis, and management of metabolic dysfunction-associated steatotic liver disease in cardiovascular disease via modified Delphi approach. Circulation 151, 98–119 (2025).

Article  PubMed  Google Scholar 

Riazi, K. et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 7, 851–861 (2022).

Article  CAS  PubMed  Google Scholar 

Lekakis, V. & Papatheodoridis, G. V. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur. J. Intern. Med. 122, 3–10 (2024).

Article  CAS  PubMed  Google Scholar 

Lee, E. C. Z. et al. The global epidemic of metabolic fatty liver disease. Curr. Cardiol. Rep. 26, 199–210 (2024).

Article  PubMed  Google Scholar 

Chew, N. W. S. et al. The global burden of metabolic disease: data from 2000 to 2019. Cell Metab. 35, 414–428.e413 (2023).

Article  CAS  PubMed  Google Scholar 

Chan, W.-K. et al. Metabolic dysfunction-associated steatotic liver disease (MASLD): a state-of-the-art review. J. Obes. Metab. Synd. 32, 197–213 (2023).

Article  Google Scholar 

Younossi, Z. M. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology 77, 1335–1347 (2023).

Article  PubMed  Google Scholar 

Zannad, F., Sanyal, A. J., Butler, J., Miller, V. & Harrison, S. A. Integrating liver endpoints in clinical trials of cardiovascular and kidney disease. Nat. Med. 30, 2423–2431 (2024).

Article  CAS  PubMed  Google Scholar 

Hagström, H., Shang, Y., Hegmar, H. & Nasr, P. Natural history and progression of metabolic dysfunction-associated steatotic liver disease. Lancet Gastroenterol. Hepatol. 9, 944–956 (2024).

Article  PubMed  Google Scholar 

Huang, D. Q. et al. Metabolic dysfunction-associated steatotic liver disease in adults. Nat. Rev. Dis. Prim. 11, 14 (2025).

Article  PubMed  Google Scholar 

Swinburn, B. A. et al. The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. Lancet 393, 791–846 (2019).

Article  PubMed  Google Scholar 

Ndumele, C. E. et al. Cardiovascular–kidney–metabolic health: a presidential advisory from the American Heart Association. Circulation 148, 1606–1635 (2023).

Article  PubMed  Google Scholar 

Zoccali, C. & Zannad, F. Refocusing cardio-renal problems: the cardiovascular–kidney–metabolic syndrome and the chronic cardiovascular–kidney disorder. Nephrol. Dial. Transpl. 39, 1378–1380 (2024).

Article  Google Scholar 

Chew, N. W. S., Muthiah, M. D. & Sanyal, A. J. in Cardiovascular Endocrinology and Metabolism (eds Krentz, A. J. & Chilton, R. J.) 137–173 (Academic Press, 2023).

Targher, G., Byrne, C. D. & Tilg, H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut 73, 691–702 (2024).

CAS  PubMed  Google Scholar 

Roca-Fernandez, A. et al. Liver disease is a significant risk factor for cardiovascular outcomes — a UK Biobank study. J. Hepatol. 79, 1085–1095 (2023).

Article  CAS  PubMed  Google Scholar 

Chen, J. et al. Risk of incident cardiovascular disease among patients with gastrointestinal disorder: a prospective cohort study of 330,751 individuals. Eur. Heart J. Qual. Care Clin. Outcomes 10, 357–365 (2024).

Article  PubMed  Google Scholar 

Lee, H. H. et al. Metabolic dysfunction-associated steatotic liver disease and risk of cardiovascular disease. Gut 73, 533–540 (2024).

Article  CAS  PubMed  Google Scholar 

Pálsson, R. & Patel, U. D. Cardiovascular complications of diabetic kidney disease. Adv. Chronic Kidney Dis. 21, 273–280 (2014).

Article  PubMed  PubMed Central  Google Scholar 

Khayyat-Kholghi, M., Oparil, S., Davis, B. R. & Tereshchenko, L. G. Worsening kidney function is the major mechanism of heart failure in hypertension: the ALLHAT study. JACC Heart Fail. 9, 100–111 (2021).

Article  PubMed  Google Scholar 

Arrese, M. et al. Insights into nonalcoholic fatty-liver disease heterogeneity. Semin. Liver Dis. 41, 421–434 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lonardo, A. The heterogeneity of metabolic syndrome presentation and challenges this causes in its pharmacological management: a narrative review focusing on principal risk modifiers. Expert. Rev. Clin. Pharmacol. 16, 891–911 (2023).

Article  CAS  PubMed  Google Scholar 

Raverdy, V. et al. Data-driven cluster analysis identifies distinct types of metabolic dysfunction-associated steatotic liver disease. Nat. Med. 30, 3624–3633 (2024).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Stefan, N., Yki-Järvinen, H. & Neuschwander-Tetri, B. A. Metabolic dysfunction-associated steatotic liver disease: heterogeneous pathomechanisms and effectiveness of metabolism-based treatment. Lancet Diabetes Endocrinol. 13, 134–148 (2025).

Article  CAS  PubMed  Google Scholar 

Stefan, N. & Targher, G. Clusters of metabolic dysfunction-associated steatotic liver disease for precision medicine. Nat. Rev. Gastroenterol. Hepatol. 22, 226–227 (2025).

PubMed  Google Scholar 

Thomas, G. et al. Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 6, 2364–2373 (2011).

Article  PubMed  PubMed Central  Google Scholar 

Yki-Järvinen, H. Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome. Lancet Diabetes Endocrinol. 2, 901–910 (2014).

Article  PubMed  Google Scholar 

Ng, T. P. et al. Metabolic syndrome and the risk of mild cognitive impairment and progression to dementia: follow-up of the Singapore Longitudinal Ageing Study cohort. JAMA Neurol. 73, 456–463 (2016).

Article  PubMed  Google Scholar 

Ben Assayag, E. et al. Type 2 diabetes mellitus and impaired renal function are associated with brain alterations and poststroke cognitive decline. Stroke 48, 2368–2374 (2017).

Article  PubMed  Google Scholar 

Giovannucci, E. et al. Diabetes and cancer: a consensus report. CA Cancer J. Clin. 60, 207–221 (2010).

PubMed  Google Scholar 

Esposito, K., Chiodini, P., Colao, A., Lenzi, A. & Giugliano, D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care 35, 2402–2411 (2012).

Article  PubMed  PubMed Central