| AASLD indicated that the most common cause of death in patients with MASLD was related to CVDs. Liver-related mortality was reported to be the second or third cause of death, and cancer-related mortality was among top three causes of death. Incidence of three complications was investigated in 552 Japanese patients with biopsy-proven MASLD. The yearly incidence rates of CVDs, malignancies, and liver-related events were found to be 1.0%, 0.8%, and 0.3%, respectively. The impacts of diet and exercise, and diabetes therapeutics were evaluated in MASLD patients. Regarding diet and exercise treatment, subjects of retrospective cohort study were cumulative total of 638 Japanese SLD patients. All of them were introduced hospitalization program of personalized diet and exercise for 6 days. Liver function tests, physical findings, and CVD risk score at 6 months improved significantly. Especially, regular and repeated hospitalizations every 6 months were effective for improvement of liver function at 2 years. Regarding diabetes therapeutics, histological impacts at 5 years after start of SGLT2 inhibitors were investigated retrospectively in 6 Japanese patients with MASLD and T2DM. Histological improvement, defined as decrease in MASLD activity score of one point or more without worsening in fibrosis stage, was 50%, and none developed CVDs. In conclusion, the most common event in Japanese MASLD patients was CVDs. Personalized medicine with diet and exercise, and diabetes therapeutics are expected to improve the pathology of MASLD, including the suppression of CVDs and liver-related events. |
