Incident venous thromboembolism in biopsy-proven metabolic dysfunction-associated steatotic liver disease : a nationwide cohort study
Yuan, Shuai ; Ebrahimi, Fahim ; Forss, Anders ; Sun, Jiangwei ; Zöller, Bengt LU
; Hagström, Hannes
and Ludvigsson, Jonas F.
(2026)
In Journal of Thrombosis and Haemostasis
24(8).
p.2910-2922
- Abstract
Background The absolute and relative risk of venous thromboembolism (VTE) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains largely unexplored. We conducted a nationwide cohort study to explore this. Objectives To calculate risk of developing VTE among MASLD. Methods This nationwide, population-based matched cohort study in Sweden included all individuals with biopsy-confirmed MASLD (1965-2017). MASLD was histologically classified into simple steatosis, metabolic dysfunction-associated steatohepatitis, noncirrhotic fibrosis, and cirrhosis. Each MASLD case was matched to up to 5 general population comparators. VTE events were identified using the Swedish National Patient Register up until 2021.... (More)
Background The absolute and relative risk of venous thromboembolism (VTE) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains largely unexplored. We conducted a nationwide cohort study to explore this. Objectives To calculate risk of developing VTE among MASLD. Methods This nationwide, population-based matched cohort study in Sweden included all individuals with biopsy-confirmed MASLD (1965-2017). MASLD was histologically classified into simple steatosis, metabolic dysfunction-associated steatohepatitis, noncirrhotic fibrosis, and cirrhosis. Each MASLD case was matched to up to 5 general population comparators. VTE events were identified using the Swedish National Patient Register up until 2021. Results We included 11 073 individuals with MASLD and 50 078 comparators. During a median follow-up of 18.6 years, incident VTE occurred in 1291 patients with MASLD and 4067 comparators. The incidence rate of VTE was higher in MASLD (7.6 vs 3.4 per 1000 person-years [PYs]), yielding an adjusted hazard ratio (aHR) of 1.78 (95% CI, 1.65-1.91). The absolute risk difference was 3.9 per 1000 PYs, equating to 1 extra VTE per 26 patients with MASLD over 10 years. MASLD was associated with a higher incidence of VTE triggered by cancer, hospitalization, and surgery. Higher aHRs were observed in women compared with men, and in patients with baseline cancer or metabolic disorders compared with those without. The risk of portal vein thrombosis was markedly elevated (aHR, 3.40; 95% CI, 2.93-3.95), increasing progressively with MASLD severity ( P = .003). Findings were similar when siblings were used as comparators to account for intrafamilial confounding. Conclusion Biopsy-confirmed MASLD was associated with a higher incidence of VTE, particularly portal vein thrombosis.
(Less)
- author
- Yuan, Shuai
; Ebrahimi, Fahim
; Forss, Anders
; Sun, Jiangwei
; Zöller, Bengt
LU
; Hagström, Hannes
and Ludvigsson, Jonas F.
- organization
- publishing date
- 2026-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cohort study, liver, fatty, thromboembolism, venous
- in
- Journal of Thrombosis and Haemostasis
- volume
- 24
- issue
- 8
- pages
- 13 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:42102922
- scopus:105039767049
- ISSN
- 1538-7933
- DOI
- 10.1016/j.jtha.2026.04.019
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2026 The Author(s).
- id
- d7cd51bf-d667-4a1e-9d13-bdeffb345049
- date added to LUP
- 2026-09-22 15:49:30
- date last changed
- 2026-09-22 15:50:05
@article{d7cd51bf-d667-4a1e-9d13-bdeffb345049,
abstract = {{<p>Background The absolute and relative risk of venous thromboembolism (VTE) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains largely unexplored. We conducted a nationwide cohort study to explore this. Objectives To calculate risk of developing VTE among MASLD. Methods This nationwide, population-based matched cohort study in Sweden included all individuals with biopsy-confirmed MASLD (1965-2017). MASLD was histologically classified into simple steatosis, metabolic dysfunction-associated steatohepatitis, noncirrhotic fibrosis, and cirrhosis. Each MASLD case was matched to up to 5 general population comparators. VTE events were identified using the Swedish National Patient Register up until 2021. Results We included 11 073 individuals with MASLD and 50 078 comparators. During a median follow-up of 18.6 years, incident VTE occurred in 1291 patients with MASLD and 4067 comparators. The incidence rate of VTE was higher in MASLD (7.6 vs 3.4 per 1000 person-years [PYs]), yielding an adjusted hazard ratio (aHR) of 1.78 (95% CI, 1.65-1.91). The absolute risk difference was 3.9 per 1000 PYs, equating to 1 extra VTE per 26 patients with MASLD over 10 years. MASLD was associated with a higher incidence of VTE triggered by cancer, hospitalization, and surgery. Higher aHRs were observed in women compared with men, and in patients with baseline cancer or metabolic disorders compared with those without. The risk of portal vein thrombosis was markedly elevated (aHR, 3.40; 95% CI, 2.93-3.95), increasing progressively with MASLD severity ( P = .003). Findings were similar when siblings were used as comparators to account for intrafamilial confounding. Conclusion Biopsy-confirmed MASLD was associated with a higher incidence of VTE, particularly portal vein thrombosis.</p>}},
author = {{Yuan, Shuai and Ebrahimi, Fahim and Forss, Anders and Sun, Jiangwei and Zöller, Bengt and Hagström, Hannes and Ludvigsson, Jonas F.}},
issn = {{1538-7933}},
keywords = {{cohort study; liver, fatty; thromboembolism; venous}},
language = {{eng}},
number = {{8}},
pages = {{2910--2922}},
publisher = {{Elsevier}},
series = {{Journal of Thrombosis and Haemostasis}},
title = {{Incident venous thromboembolism in biopsy-proven metabolic dysfunction-associated steatotic liver disease : a nationwide cohort study}},
url = {{http://dx.doi.org/10.1016/j.jtha.2026.04.019}},
doi = {{10.1016/j.jtha.2026.04.019}},
volume = {{24}},
year = {{2026}},
}