Hepatology Internationalhttp5/doi.org/10.1007/s12072-023-10543-8CONSENSUSAn international multidisciplinary consensus statement on MAFLDand the risk of CVDXiao-Dong Zhou'.Giovanni Targher2.Christopher D.Byrne3.Virend Somers4.Seung Up Kims.C.Anwar A.Chahals47.Vincent Wai-Sun Wong.Jingjing Cai.Michael D.Shapiro10.Mohammed Eslam11.Philippe Gabriel Steg12.Ki-Chul Sung13.Anoop Misra14.Jian-Jun Li15.Carlos Brotons16.Yuli Huang17.George V.Papatheodoridis18.Aijun Sun19.Yusuf Yilmaz20.21.Wah Kheong Chan22.Hui Huang23.Nahum Mendez-Sanchez24.Saleh A.Alqahtani25,26.Helena Cortez-Pinto27.Gregory Y.H.Lip28.29Robert J.de Knegt30.Ponsiano Ocama31.Manuel Romero-Gomez32.Marat Fudim33.34.Giada Sebastiani5Jang Won Son36.John D.Ryan37.Ignatios lkonomidis38.Sombat Treeprasertsuk39.Daniele Pastori40.Monica Lupsor-Platon1.Herbert Tilg2.Hasmik Ghazinyan43.Jerome Boursier4445.Masahide Hamaguchi46.Mindie H.Nguyen4748.Jian-Gao Fan49.George Boon-Bee Gohso.Mamun Al Mahtab51.Saeed Hamid52.Nilanka Pereras3.Jacob George11.Ming-Hua Zheng54,55,56Received:19 March 2023/Accepted:18 April 2023Asian Pacific Association for the Study of the Liver 2023AbstractBackground Fatty liver disease in the absence ofexcessive alcohol consumption is an increasingly common condition with aglobal prevalence of~25-30%and is also associated with cardiovascular disease(CVD).Since systemic metabolic dysfunc-tion underlies its pathogenesis,the term metabolic(dysfunction)-associated fatty liver disease (MAFLD)has been proposedfor this condition.MAFLD is closely intertwined with obesity,type 2 diabetes mellitus and atherogenic dyslipidemia,whichare established cardiovascular risk factors.Unlike CVD,which has received attention in the literature on fatty liver disease,the CVD risk associated with MAFLD is often underestimated,especially among Cardiologists.Methods and results A multidisciplinary panel of fifty-two international experts comprising Hepatologists,Endocrinologists,Diabetologists,Cardiologists and Family Physicians from six continents (Asia,Europe,North America,South America,Africa and Oceania)participated in a formal Delphi survey and developed consensus statements on the association betweenMAFLD and the risk of CVD.Statements were developed on different aspects of CVD risk,ranging from epidemiology tomechanisms,screening,and management.Conculsions The expert panel identified important clinical associations between MAFLD and the risk of CVD that couldserve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD.Finally,the expert panel alsosuggests potential areas for future research.Keywords Metabolic (dysfunction)-associated fatty liver disease.MAFLD.Non-alcoholic fatty liver disease.Cardiovascular disease.Consensus.Delphi surveyIntroductionNonalcoholic fatty liver disease (NAFLD)is the most com-mon chronic liver condition worldwide,with an estimatedglobal prevalence of 25-30%[1].Although it is recognizedthat NAFLD is linked to insulin resistance,overweight/obesity
