The Effect of Cardiometabolic Drugs on Non-Alcoholic Fatty Liver Disease (NAFLD), Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

The link between cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated fatty liver disease (MAFLD)/metabolic dys-function-associated steatotic liver disease (MASLD) is well-established at both epidemi-ological and pathophysiological level. Among the common pathophysiological mechanisms involved in the development and progression of both diseases, oxidative stress and inflammation, insulin resistance, lipid metabolism deterioration, gut dysbiosis along with genetic factors have been rec-ognized to play a pivotal role. Pharmacologic interventions with drugs targeting common modifiable cardiometabolic risk factors, such as T2DM, dyslipidemia, and hypertension is a reasonable strategy to prevent CVD development and progression of MASLD. Recently, a novel drug for MASH, resmetirom, has shown positive effects regarding CVD risk, opening new opportunities for the therapeutic approach of NAFLD/MAFLD/MASLD and CVD. This review provides current knowledge on the epidemiologic association of NAFLD/MAFLD/MASLD to CVD morbidity and mortality and enlightens the possible underlying pathophysiologic mechanisms linking NAFLD/MAFLD/MASLD with CVD. It also highlights potential common therapeutic interventions with cardiometabolic drugs such as anti-hypertensive drugs, hypolipidemic agents, glucose-lowering medications, salicylic acid and the thyroid hormone receptor-beta agonist that may improve outcomes of NAFLD/MAFLD/MASLD.