Predictive factors of metabolic dysfunction associated steatotic liver disease (MASLD) among individuals with cardio-metabolic risk factors, multicenter cross-sectional study, North East Ethiopia

BACKGROUND: Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as NAFLD, is a growing global public health concern, affecting 30–40% of the population. Its epidemiology in sub-Saharan Africa, including Ethiopia, is still under-investigated. This study aimed to assess the prevalence of MASLD and its associated factors among individuals with cardio metabolic risk factors. METHODS: An institution-based cross-sectional study was conducted among adults with cardio metabolic risk factors attending follow-up clinics. Data on clinical, anthropometric, biochemical, and ultrasound findings were collected. Descriptive statistics, bivariate, and multivariable logistic regression analysis was performed to identify factors associated with metabolic dysfunction-associated steatotic liver disease. A p-value of < 0.05 was considered statistically significant. RESULT: The prevalence of MASLD was found to be 28.1%. Females were nearly twice as likely to develop MASLD compared to males (AOR = 1.96; 95% CI: 1.08–3.53; P = 0.026). Individuals with diabetes mellitus were more likely to have MASLD than their non-diabetic counterparts (AOR = 1.71; 95% CI: 1.01–2.87; P = 0.044). Study Participants with abnormal body mass index were almost three times more likely to have MASLD compared to those with normal body mass index (AOR = 2.98; 95% CI: 1.08–8.21; P = 0.034). Abnormal waist circumference (AOR = 2.31; 95% CI: 1.22–4.35; P = 0.009) and high triglyceride levels (AOR = 2.27; 95% CI: 1.36–3.77; P = 0.002) were also independent predictors of MASLD. CONCLUSION AND RECOMMENDATION: Nearly one-third of the study participants had MASLD, with diabetes mellitus, dyslipidaemia, increased waist circumference, and overweight significantly associated with its prevalence. These findings highlight the urgent need for targeted screening and early intervention among individuals with multiple cardio metabolic risk factors to prevent MASLD progression and reduce the risk of liver-related and systemic complications.