A cardiometabolic risk phenotype index integrating insulin resistance, systemic inflammation, and psychological burden for mortality risk stratification in metabolic dysfunction-associated steatotic liver disease: an exploratory longitudinal analysis of a nationally representative cohort

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is being increasingly recognized as a systemic cardiometabolic disorder rather than a liver-limited condition. However, the combined association of insulin resistance, systemic inflammation, and depressive symptoms with mortality remains unclear. Therefore, we developed an insulin resistance-systemic inflammation-psychological burden (ISP) index to evaluate its associations with all-cause mortality (ACM) and cardiovascular mortality (CVM).