Young adults with overweight/obesity-related metabolic dysfunction–associated steatotic liver disease showed higher rates of left-ventricular hypertrophy (LVH) and diastolic dysfunction by middle age compared with both lean peers and those with overweight/obesity alone, according to a 15-year analysis from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
The cohort included 1,983 participants aged 28–39 at baseline (1995–1996) who underwent echocardiography 15 years later (2010–2011). Participants were classified as lean, overweight/obese, or overweight/obese with metabolic dysfunction–associated steatotic liver disease (MASLD) at baseline.
The research, conducted by Jai-Jie Wang and colleagues, was chosen as a 2025 Arthur E. Weyman Young Investigator’s Award Competition Finalist. Findings were presented at the American Society of Echocardiography 2025 annual meeting and as an abstract in the Journal of the American Society of Echocardiography.
Compared with the overweight/obese group without liver involvement, those with overweight/obesity-related MASLD had 1.6 times the risk of left-ventricular hypertrophy (95% CI, 1.36–1.88) and 1.62 times the risk of elevated filling pressure (95% CI, 1.19–2.21).
Systolic function was preserved across groups after full adjustment. There was no significant difference in the prevalence of ejection fraction less than 55% (overweight/obese relative risk [RR] 0.67 [0.36–1.24]; overweight/obese + MASLD RR 0.93 [0.41–2.12]).
LVH was defined as a mass greater than 224 grams for men and greater than 162 grams for women, noted Wang, of the Guangdong provincial people's hospital, Guangzhou, China, and colleagues.
Findings point to a graded, stepwise association from lean to overweight/obese to overweight/obese with MASLD for adverse LV remodeling and diastolic abnormalities. While causality cannot be inferred from this observational study, the data suggest that identifying MASLD in young adults with excess adiposity may refine cardiovascular risk assessment and highlight a window for earlier preventive strategies—particularly for diastolic dysfunction and LV mass progression—before any decline in ejection fraction.
Disclosures were not available at press time.
