Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive triglyceride accumulation in the liver, the presence of one or more cardiometabolic risk factors, and an absence of harmful alcohol intake. Oxidative stress plays a crucial role in the development and severity of this disease, contributing to an increased cardiovascular risk (CVR). Malondialdehyde (MDA), an oxidative biomarker resulting from lipid peroxidation, is closely associated with metabolic dysfunction. This study aimed to evaluate the role of MDA as a predictor of steatosis severity and CVR. Methodology: An observational cross-sectional study was conducted in a population with MASLD with hepatic steatosis confirmed by ultrasonography and computed tomography. Subjects were classified according to severity of the hepatic steatosis as grade I or grade II-III. Nutritional, anthropometric, and serum biochemical parameters were measured. MDA levels were determined using a spectrophotometric method. The CVR was assessed using waist-to-hip ratio (WHR), triglycerides-glucose (TyG) index, lipid accumulation product (LAP), and atherogenic index of plasma (AIP). Receiver operating characteristic (ROC) curve analysis was performed to identify MDA cut-off value, followed by multivariable logistic regression to assess its association with severity of steatosis adjusted for body fat percentage. Results: A total of 50 patients were included (21 men and 29 women). An MDA cut-off value ≥ 0.13 nmol/mL was associated with higher severity (grade II–III vs. grade I) (OR = 5.0; 95% CI: 1.20–20.0; p = 0.022). Higher WHR values were found in subjects with grade I (p = 0.049), and elevated TyG index values were observed in patients with grade I-III (p = 0.042) both indicating increased CVR. Conclusions: Elevated MDA levels and higher body fat percentage were associated with higher degree of hepatic steatosis and increased CVR in the population from southeastern Mexico.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasingly prevalent disease closely linked to dietary habits and body composition, particularly reflected in lean mass and markers such as appendicular skeletal muscle mass (ASM). Low ASM can subsequently trigger metabolic abnormalities such as metabolic syndrome (MetS). This study aimed to evaluate the relationships between the diet quality index, ASM, and MetS in individuals with MASLD from the Yucatan Peninsula. Methods: A cross-sectional study was conducted in subjects with a MASLD diagnosis. Diet quality index, anthropometric and biochemical parameters were evaluated. Body composition analysis was utilized to estimate ASM. Correlations between ASM and anthropometric/biochemical parameters were analyzed. Furthermore, comparative analyses were performed between groups stratified by the presence of MetS and low ASM. Results: Fifty subjects were included in the study. Participants exhibited a significantly low diet quality index (57.6 ± 9.78 vs. 100, p < 0.001), alongside a high prevalence of both low ASM and MetS. ASM was positively correlated with BW, WC, and protein mass (p < 0.001), as well as with creatinine and ALT (p < 0.05), and negatively correlated with body fat percentage and TG (p < 0.05). Subjects with low ASM showed significant differences in BW, waist circumference, protein mass, and energy intake compared to those with normal ASM (p < 0.05). Individuals with MetS had higher glucose and blood pressure compared to non-MetS (p < 0.05). Additionally, among patients with MASLD and MetS, those with low ASM exhibited higher glucose and systolic blood pressure compared to those with normal ASM (p < 0.05). Conclusions: Our study demonstrates that adults with MASLD from the Yucatan Peninsula exhibited suboptimal diet quality according to the DQI-I, with a high prevalence of low ASM and MetS. These findings highlight the potential role of the muscle–liver axis in metabolic dysfunction in MASLD.

Aims: Iron deficiency (ID) is common amongst patients with ST-elevation myocardial infarction (STEMI). Its impact on outcomes remains contested. Previous studies reported favourable or adverse impacts depending on outcome measures, sampling timepoints, ID definition and follow-up duration. This study systematically characterises the prognostic impact of iron status on short-term, mid-term and long-term outcomes, and evaluates the effect of sampling timepoint and ID definition on these prognostic relationships. Methods & Results: We performed an observational cohort study in patients with acute STEMI (n = 167) and no prior heart failure (HF). Iron markers were sampled at presentation, and successive timepoints thereafter. Cardiac Magnetic Resonance was performed at 2 days and 6 months. Major adverse cardiovascular events (MACE), consisting of new-onset HF, recurrent MI or cardiac death were recorded over 4.5 years. Mechanisms were evaluated in a preclinical model of MI. ID was common at presentation, affecting between 44.9% and 67%, depending on ID definition. Tsat <20%, serum iron<13μM, or European Society of Cardiology’s definition, but not ferritin<100μg/L, independently predicted lower risk of MACE. Lower Tsat at presentation predicted attenuated infarct and non-infarct T1, and smaller left ventricular volumes at 2 days. This prognostic effect was weakened by delayed sampling. Lower Tsat and serum iron in the post-acute timepoints, but not at presentation, predicted lower myocardial salvage at 6 months. In mice, MI triggered an acute myocardial labile iron storm and early LV remodelling, progressing to HF. Baseline ID and acute iron chelation averted these effects. Conclusions: This study gives rise to the hypothesis that ID at presentation with STEMI improves long-term outcomes by attenuating myocardial injury. It reconciles previous conflicting reports by revealing the confounding effects of delayed sampling, and non-interchangeability of different ID definitions. It suggests iron chelation in the acute stage, followed by post-acute iron repletion might improve long-term outcomes.