The association between hepatic fibrosis indicators and subclinical carotid atherosclerosis in the population with metabolic dysfunction-associated steatotic liver disease under 50 years old.

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) and subclinical carotid atherosclerosis (SCA) share common roots in systemic inflammation and metabolic dysregulation. Hepatic fibrosis mirrors the intensity of these disturbances; however, its association with SCA in younge...

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Published in:Nutrition & Metabolism Vol. 22; no. 1; pp. 1 - 16
Main Authors: Zhang, Shuai, Liang, Hao, Liu, Jun, Zhu, Ye
Format: pictorial research tables/charts Journal Article
Published: BioMed Central 11/10/2025
Online Access:View this record in EBSCOhost
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      dt: 11/10/2025
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      pub: BioMed Central
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        10.1186/s12986-025-01039-3
        189234928
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        atl: The association between hepatic fibrosis indicators and subclinical carotid atherosclerosis in the population with metabolic dysfunction-associated steatotic liver disease under 50 years old.
      aug:
        au:
          Zhang, Shuai
          Liang, Hao
          Liu, Jun
          Zhu, Ye
        affil: https://ror.org/04gz17b59 Department of Gastroenterology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225001, Yangzhou, China
      sug:
        subj:
          Metabolic Diseases Complications
          Nonalcoholic Fatty Liver Disease Risk Factors
          Carotid Artery Diseases Risk Factors
          Inflammation
          Age Factors
          Risk Assessment
          Human
          Funding Source
          Male
          Female
          Adult
          Middle Age
          Adolescence
          Young Adult
          Retrospective Design
          Record Review
          Cross Sectional Studies
          Health Screening
          Hypertension
          Diabetes Mellitus
          Coronary Disease
          Hospital Information Systems
          Diagnostic Tests, Routine
          Physicians
          Descriptive Statistics
          Multiple Logistic Regression
          Spearman's Rank Correlation Coefficient
          Correlational Studies
          Mediation Analysis
          Body Mass Index
          ROC Curve
          Carotid Artery Diseases Classification
          Odds Ratio
          Confidence Intervals
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) and subclinical carotid atherosclerosis (SCA) share common roots in systemic inflammation and metabolic dysregulation. Hepatic fibrosis mirrors the intensity of these disturbances; however, its association with SCA in younger adults remains unclear. Methods: A total of 14 567 MASLD patients were enrolled from the health examination center of Northern Jiangsu People's Hospital. Participant stratification into SCA and non-SCA groups was based on carotid ultrasound findings. Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression. The associations between the selected indicators and SCA risk were subsequently evaluated through multivariate logistic regression, restricted cubic spline (RCS) analysis, subgroup analysis, receiver operating characteristic (ROC) curves, and mediation analysis. Results: Both LASSO and multivariate logistic regression analyses demonstrated that elevated NAFLD Fibrosis Score (NFS) and Fibrosis-4 (FIB-4) levels were positively correlated with the prevalence of SCA in patients with MASLD (P for trend < 0.001). Mediation analysis indicated that the Red-cell Distribution Width-to-Albumin Ratio (RAR) significantly mediated this association, with the mediated proportion ranging from 28.6% to 44.6% (P < 0·05). Subgroup analysis identified a significant interaction between age and the association of both fibrosis scores with SCA (P for interaction < 0.05). Subsequently, RCS analysis demonstrated significant positive non-linear associations between NFS/FIB-4 and SCA risk specifically in patients aged under 50 years (P for non-linear < 0.001). The area under the ROC curve (AUC) indicated that both scores had fair predictive value for SCA in this younger subgroup. Conclusion: This study confirms that elevated NFS and FIB-4 levels are significantly associated with an increased risk of SCA in MASLD patients, demonstrating a distinct non-linear relationship and fair predictive value, particularly in individuals under 50 years of age.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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