Association of HsCAR with MAFLD and Liver Fibrosis: a Cross-sectional Study

Inclusion Criteria:

• Total participants from NHANES 2017-2020

• Participants diagnosed with MAFLD. Metabolic dysfunction-associated fatty liverdisease (MAFLD) is the term used to describe hepatic steatosis in the presence ofmetabolic abnormalities, excess weight, obesity, or type 2 diabetic mellitus.

1. Diagnosis of diabetes mellitus: (1) taking glucose-lowering drugs; (2) HbA1c ≥ 6.5% (48 mmol/mol); (3) fasting plasma glucose ≥ 7.0 mmol/L (126 mg/dL); (4) 2-hour plasma glucose (2hPG) ≥ 11.1 mmol/L (200 mg/dL).

2. Overweight or obesity: defined as BMI≥25 kg/m2 in Caucasians or BMI≥23 kg/m2 inAsians

3. If presence of at least two metabolic risk abnormalities:

• Waist circumference≥102/88 cm in Caucasian men and women (or≥90/80 cm inAsian men and women)
• Blood pressure≥130/85 mmHg or specific drug treatment
• Plasma triglycerides≥150 mg/dl (≥1.70 mmol/L) or specific drug treatment
• Plasma HDL-cholesterol <40 mg/dl (<1.0 mmol/L) for men and <50 mg/dl (<1.3mmol/L) for women or specific drug treatment
• Prediabetes (i.e., fasting glucose levels 100 to 125 mg/dl [5.6 to 6.9mmol/L], or 2-hour post-load glucose levels 140 to 199 mg/dl [7.8 to 11.0mmol] or HbA1c 5.7% to 6.4% [39 to 47 mmol/mol])
• Homeostasis model assessment of insulin resistance score≥2.5
• Plasma high-sensitivity C-reactive protein level >2 mg/L

Exclusion Criteria:

• Liver ultrasound data not available

• participants without complete clinical data

• participants under 18 years old

• participants with cancer.